Purpose: The purpose was to prospectively evaluate the two-year results after implantation of the Journey PFJ(®) (Smith & Nephew, Andover, MA). The authors hypothesized that patellofemoral arthroplasty would result in improved outcomes after 24 months in patients treated with an isolated procedure as well as in patients demonstrating concomitant patellofemoral instability (PFI), which were treated with a combined surgical procedure.
Methods: Patients were included between 02/2006 and 08/2008. According to the history and clinical findings, patients were grouped into group I with no history or clinical signs of PFI, and patients with concomitant PFI were assorted to group II. Patients were then treated with an isolated (group I) or a combined (group II) surgical procedure to additionally treat the PFI. Visual analogue scale (VAS), Lysholm score and WOMAC score were recorded preoperatively, 6, 12 and 24 months postoperatively. Patellar height was evaluated according to the index of Caton-Deschamps (CDI), and osteoarthritic changes were evaluated according to Kellgren and Lawrence.
Results: A total of 25 patients were enrolled, of them three discontinued interventions and were excluded from final analysis. An isolated implantation of the Journey PFJ(®) was performed in 14 patients (group I) and a combined procedure in 8 (group II). Daily pain and clinical scores significantly improved at 6, 12 and 24 months compared to preoperative values (P < 0.05). Significant decrease (P = 0.02) of mean CDI could be noticed. Significant increase in tibiofemoral OA within the medial but not in the lateral tibiofemoral joint was assessed (P = 0.011; n.s.).
Conclusions: Patellofemoral arthroplasty using the Journey(®) PFJ for treatment of significant patellofemoral OA demonstrated improved clinical scores at the 2-year follow-up in both groups. Comparing the primary OA (I) and OA + instability (II) groups, patients with patellofemoral OA treated with a combined procedure for concomitant stabilization of patellofemoral instability may benefit more from such a combined procedure, than patients treated with an isolated procedure for treatment of isolated patellofemoral OA.
Level Of Evidence: Prospective case series, Level III.
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http://dx.doi.org/10.1007/s00167-012-2022-6 | DOI Listing |
Cureus
December 2024
Department of Health Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JPN.
Purpose The infrapatellar fat pad (IFP) has the lowest pain threshold among all knee joint components and causes anterior knee pain after knee arthroplasty. It has been reported that selective muscle atrophy of the vastus medialis (VM) and fibrosis of the IFP may develop following knee joint surgery. Ultrasound enables visualization of IFP deformation (A1) from within the joint to the proximal area in response to muscle contraction, and this may be helpful in developing preventive and therapeutic strategies for IFP fibrosis.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
January 2025
Clinical Research Department, Sydney Knee Specialists, Kogarah, New South Wales, Australia.
Purpose: In functionally aligned (FA) total knee arthroplasty (TKA), femoral component rotation (FCR) is personalised to optimise flexion gap balance. As axial malalignment has been attributed to patellofemoral complications, this study assessed FA FCR in relation to the surgical transepicondylar axis (TEA) and early implant survivorship.
Methods: We analysed 446 robotic-assisted primary TKAs in 393 patients using FA with preresection gap balancing.
J Exp Orthop
January 2025
Orthopaedic Department, Hospital del Mar Universitat Autònoma Barcelona Barcelona Spain.
Purpose: This study aimed to analyse the clinical outcomes and survival of patellofemoral arthroplasty (PFA) in treating isolated patellofemoral osteoarthritis (IPFOA) at our centre. The secondary objective was to compare these results with a historical cohort treated with partial lateral facetectomy plus Insall realignment (PLFIR). We hypothesised that clinical outcomes and survival with PFA are superior to PLFIR and comparable to the literature.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Institute for Locomotion, Aix-Marseille University, Marseille, France.
Introduction: The aim of this study was to establish an international consensus statement on the indications for the addition of a patellofemoral joint arthroplasty (PFJA) in patients with a unicondylar knee arthroplasty (UKA) and symptomatic progression of patellofemoral compartment osteoarthritis.
Materials And Methods: A systematic review of the literature was conducted, and the results used to inform the development of a statement by an expert working group. This was then evaluated and modified, using a Delphi process, by members of the European Knee Society (EKS).
Acta Orthop
January 2025
Clinical Orthopaedic Research Hvidovre, Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
Background And Purpose: In contemporary medial unicompartmental knee arthroplasty (mUKA), non-lateral patellofemoral osteoarthritis (PFOA) is not considered a contraindication. However, we still lack knowledge on the association of PFOA severity on patient reported outcome measures (PROMs) after mUKA. We aimed to examine the association between PFOA severity and PROM-score changes after mUKA.
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