|Beitragstitel||Early advantage of Patellofemoral Arthroplasty is not Age Dependent|
Most orthopedic surgeons are restrained using isolated patellofemoral arthroplasty in patients with isolated patellofemoral joint degeneration and prefer total knee arthroplasty. While in young patients the advantage to postpone total knee arthroplasty is obvious, the advantages for middle aged and older patients are less known. The goal of this study was therefore to assess the clinical and radiographic outcomes of our series of patellofemoral arthroplasty and correlate it with patients’ age.
Retrospective case series of prospective data of 22 consecutive patients (mean age 48,3 years, 31-82 years) which were treated between 2012 and 2015 with the HemiCAP® Wave Patellofemoral Prosthesis (Arthrosurface, Franklin, MA, USA) for isolated patellofemoral arthrosis at a single center and single surgeon. Mean follow-up was 22,8 months (range, 18-30). Variables included Lysholm, WOMAC, VAS Scores, Kellgren–Lawrence grading, need for blood transfusion or inpatient rehabilitation.
16 patients with 18 implanted prostheses were available for the follow-up, two patients had bilateral resurfacing. One patient dropped out because of revision with TKA needed at 11 months postoperatively.
Of 18 prostheses, 88,9% reported a satisfactory or very satisfactory overall outcome. Significant improvements in functional scores were found in Lysholm Score (preoperative mean 50,6±22,9 to 2-years postoperative 76,4±16,7, p=0,013), WOMAC (49,2 ±19,2 to 76,3±19,1, p<0,001), VAS score (5,9±2,4 to 2.3±2, p<0,001).
No significant progression of tibiofemoral OA was observed (Kellgren-Lawrence scores for medial compartment, preoperative 1,3±0,5 to 1,5±0,8 after 2 years, p=0,44, and lateral 0,85±0,8 to 1,1±0,8, p=0,46). No patient needed blood transfusion or inpatient rehabilitation. No correlation of any variable with age has been found.
In our series, patellofemoral arthroplasty was found to be an effective procedure to treat patients with isolated patellofemoral degeneration. Even the older patients had early benefit from this procedure because of its lower morbidity and blood loss compared to the literature outcome for total knee arthroplasty.