Long-Term Outcomes of Patellofemoral Arthroplasty
Section snippets
Materials and Methods
Between December 1976 and December 2005, 185 consecutive Richards type II (Smith and Nephew, Memphis, Tenn) patellofemoral arthroplasties were performed in 161 patients with isolated patellofemoral osteoarthritis. Patients were followed up regularly with clinical and radiological examinations. After approval from the Regional Ethics Committee and Institutional Review Board, informed consent was obtained from every patient before the final follow-up analysis in 2007. Thirty-five patients (41
Results
No technical complications occurred during any surgery. Immediate postoperative radiographs confirmed adequate positioning of the prosthesis in 174 of 181 knees (96%, Fig. 2). Radiologically visible component malposition, with the distal tip of the femoral component projecting into the intercondylar notch, was observed in 7 (4%) of 181 knees. Postoperatively, 11 knees in 10 patients (6%) required manipulation under anesthesia. The indication for manipulation was failure to achieve 90° of
Discussion
Our results demonstrate an overall revision rate of 24% using the Richards type II patellofemoral arthroplasty for isolated patellofemoral osteoarthritis, with cumulative survivals of 84% and 69% after 10 and 20 years, respectively. This conversion rate is superior to the long-term follow-up conversion rates reported in the literature 26, 27. The number of knees requiring further surgery coincides with that reported in other series 12, 21, 22. A recent review reported a reoperation rate of 24%
Conclusions
Long-term outcomes of patellofemoral arthroplasty using the Richards type II prosthesis are not affected by primary diagnosis, sex, or age at patellofemoral arthroplasty. The large number of patellofemoral complications that necessitate revision for malposition could have been due to the constraining geometric properties of the Richards type II prosthesis.
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2021, Orthopaedics and TraumaCitation Excerpt :Outcomes for first-generation implants therefore were largely disappointing, with only a 53% patient satisfaction rate, and up to 42% re-operation rate reported when using the Lubinus prosthesis.20,21 However, with implant improvements, better outcomes have been reported, with satisfactory results in 86% of cases at 15–21 years,22 and long-term survivorship of 69% at 20 years when using the Richards prosthesis.18 Second-generation patellofemoral arthroplasty (‘onlay prostheses’): second-generation implants were introduced in the 1990s, and replace the entire anterior compartment of the knee.
Clinical outcomes of patellofemoral arthroplasty: robotic assistance produces superior short and mid-term outcomes
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No benefits or funds were received in support of the study.