Elsevier

The Journal of Arthroplasty

Volume 25, Issue 7, October 2010, Pages 1066-1071
The Journal of Arthroplasty

Long-Term Outcomes of Patellofemoral Arthroplasty

https://doi.org/10.1016/j.arth.2009.08.023Get rights and content

Abstract

The purpose of this study was to correlate the long-term survival of patellofemoral arthroplasty with primary diagnosis, age, sex, and body mass index. One hundred eighty-five consecutive Richards type II patellofemoral arthroplasties were performed in 161 patients with isolated patellofemoral osteoarthritis. Diagnoses included primary patellofemoral osteoarthritis, posttraumatic patellofemoral osteoarthritis, and patellofemoral osteoarthritis with a previous realignment procedure for patellar subluxation or trochlear dysplasia. Median time to follow-up was 13.3 (range, 2.0-30.6) years. Patellofemoral arthroplasty survival was 84% at 10 years and 69% at 20 years. Primary diagnosis, sex, or age at patellofemoral arthroplasty did not significantly affect the rate of revision (P = .35, P = .24, and P = .65, respectively). The rate of revision in obese patients (body mass index >30 kg/m2) was higher than that in nonobese patients (P = .02).

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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    No benefits or funds were received in support of the study.

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