The evolution and role of patellofemoral joint arthroplasty

Roussot, Mark; Haddad, FS

doi:10.1302/2046-3758.712.bjr-2018-0303

Cited by 13 publications

(15 citation statements)

References 39 publications

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“…22 Metal-backed patellar buttons decrease the available polyethylene thickness and have been shown to be more prone to fatigue failure compared to all-polyethylene implants. [25][26][27][28][29] Their use has decreased considerably across the past 10 years. 6 Correctly positioned spherical dome designs allow self-centering on the trochlea, and if revision to TKA is needed, they usually allow congruency matching the trochlear shape of the new tibiofemoral components.…”

Section: Implant Design -Trochlear Componentmentioning

confidence: 99%

“…This makes the all-polyethylene patellar button the most versatile choice and the most frequently used contemporary option. 25 The majority of PFA implants have a patellar button design such as this that theoretically allows retention when converting to TKA. As a special-circumstance consideration, the LCS PFA (DePuy) prosthesis has a metal-backed, mobile-bearing, patellar component deemed only compatible with the trochlear and femoral component in its same product line.…”

Section: Implant Design -Trochlear Componentmentioning

confidence: 99%

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Patellar button compatibility in the conversion of Patellofemoral Arthroplasty to a Total Knee Arthroplasty: A review of the contemporary literature

Anat

Kurmis

2022

J Orthop Surg (Hong Kong)

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Background Compared to total knee arthroplasty (TKA), patellofemoral arthroplasty (PFA) is a far less commonly performed operation. However, in carefully selected cohorts, PFA continues to be an appropriate treatment option for end-stage isolated patellofemoral joint osteoarthritis. In the later situation whereby a PFA is considered for conversion to a TKA – often due to disease progression – uncertainty remains regarding optimal management of the in situ patellar button. This review of the contemporary literature aimed to provide a summary of the current evidence to support surgeon decision-making, by evaluating the compatibility, efficacy, and survivorship of retained versus revised patellar buttons in PFA-to-TKA conversion. Specific focus was paid to implant design and technical considerations during revision, plus post-operative patient-reported outcomes and modes of secondary patellar component failure. Methods A review of the Embase, Cochrane and PubMed databases was performed following PRISMA search principles. Results This investigation highlights that the fate of patellar buttons in PFA-to-TKA conversion has previously been poorly studied, with scant publication data available. Most reports have been of singular cases or small cohort series. Larger formal RCTs and level 1 evidence are lacking. Conclusion The findings herein suggest that surgeons can confidently retain well-fixed, undamaged, dome-shaped all-polyethylene patellar buttons in the conversion of a PFA to TKA with the expectation of acceptable mid-term performance and survivorship, as long as congruent tracking with the new tibiofemoral components is achieved. This result is likely translatable to the majority of contemporary, all-polyethylene, dome-shaped patellar buttons, even with manufacturer mismatch.

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Section: Implant Design -Trochlear Componentmentioning

confidence: 99%

Section: Implant Design -Trochlear Componentmentioning

confidence: 99%

Patellar button compatibility in the conversion of Patellofemoral Arthroplasty to a Total Knee Arthroplasty: A review of the contemporary literature

Anat

Kurmis

2022

J Orthop Surg (Hong Kong)

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“…Technologies that allow us to place implants in the exact position in which we want them may influence our surgical goals in TKA, and we will need to utilize them efficiently in order to understand the optimal solution for our individual patients. 108,109 They may also assist in controlling some of the confounding variables that make outcomes in patellar resurfacing versus non-resurfacing difficult to compare.…”

Section: Generation ‘R’mentioning

confidence: 99%

The evolution of patellofemoral prosthetic design in total knee arthroplasty: how far have we come?

Roussot

Haddad

2019

EFORT Open Reviews

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Total knee arthroplasty (TKA) has evolved into a successful, cost-effective treatment for end-stage knee arthrosis. The patellofemoral articulation in TKA has largely been ignored during its development despite being an important determinant of outcome. New technologies still need further development to incorporate the patella in TKA surgical planning and operative technique. Alternative approaches to alignment in TKA will have a secondary impact on patellofemoral mechanics and possibly future implant designs. Technologies that assist with precise implant positioning may alter our understanding and overall practice of TKA. Cite this article: EFORT Open Rev 2019;4:503-512. DOI: 10.1302/2058-5241.4.180094

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“… 8 - 11 Consequently, there has been much recent debate in the orthopaedic community regarding how to improve knee function and patient satisfaction following arthroplasty. 9 , 12 - 16 …”

Section: Introductionmentioning

confidence: 99%

The extensor efficiency of unicompartmental, bicompartmental, and total knee arthroplasty

Garner

Dandridge

Amis

et al. 2021

Bone & Joint Research

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Aims Unicompartmental knee arthroplasty (UKA) and bicompartmental knee arthroplasty (BCA) have been associated with improved functional outcomes compared to total knee arthroplasty (TKA) in suitable patients, although the reason is poorly understood. The aim of this study was to measure how the different arthroplasties affect knee extensor function. Methods Extensor function was measured for 16 cadaveric knees and then retested following the different arthroplasties. Eight knees underwent medial UKA then BCA, then posterior-cruciate retaining TKA, and eight underwent the lateral equivalents then TKA. Extensor efficiency was calculated for ranges of knee flexion associated with common activities of daily living. Data were analyzed with repeated measures analysis of variance (α = 0.05). Results Compared to native, there were no reductions in either extension moment or efficiency following UKA. Conversion to BCA resulted in a small decrease in extension moment between 70° and 90° flexion (p < 0.05), but when examined in the context of daily activity ranges of flexion, extensor efficiency was largely unaffected. Following TKA, large decreases in extension moment were measured at low knee flexion angles (p < 0.05), resulting in 12% to 43% reductions in extensor efficiency for the daily activity ranges. Conclusion This cadaveric study found that TKA resulted in inferior extensor function compared to UKA and BCA. This may, in part, help explain the reported differences in function and satisfaction differences between partial and total knee arthroplasty. Cite this article: Bone Joint Res 2021;10(1):1–9.

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The evolution and role of patellofemoral joint arthroplasty

Cited by 13 publications

References 39 publications

Patellar button compatibility in the conversion of Patellofemoral Arthroplasty to a Total Knee Arthroplasty: A review of the contemporary literature

Patellar button compatibility in the conversion of Patellofemoral Arthroplasty to a Total Knee Arthroplasty: A review of the contemporary literature

The evolution of patellofemoral prosthetic design in total knee arthroplasty: how far have we come?

The extensor efficiency of unicompartmental, bicompartmental, and total knee arthroplasty

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