Background: Up to 45% of patients who undergo primary total knee arthroplasty (TKA) with contemporary implants have residual anterior knee pain. While a specific evaluation of anterior knee symptoms is mandatory, little is known about the capability of patellofemoral scores to be used individually. This study aimed to assess the distribution of patellofemoral scores after TKA from a uniform cohort and to investigate their external validity and ability to detect anterior knee symptoms using floor and ceiling effects.
Hypothesis: Patellofemoral scores have high construct validity and fewer floor/ceiling effects than general knee scores.
Methods: We prospectively included 113 consecutive patients who underwent primary TKA for primary osteoarthritis at a single University Hospital. Clinical outcomes included patellofemoral scores (HSS Patella, Kujala and Lille scores) and general knee scores (KOOS and new KSS) at 1-year follow-up. The floor and ceiling effects were considered as significant when greater than 15%. These were determined for each score individually and for composite scores (combination of patellofemoral scores and new KSS). The construct validity of each score and their ability to detect anterior knee pain was evaluated.
Results: Patellofemoral scores showed no floor effect but a significant ceiling effect (from 25% to 65%). This ceiling effect decreased when composite scores were used. The convergent validity test showed strong correlation between patellofemoral scores (from 0.741 to 0.819, p<0.00001) and a better ability to discriminate anterior knee pain than the general knee scores.
Conclusions: Patellofemoral scores showed no floor effect and a very good construct validity for anterior knee pain after TKA. However, studies aiming to monitor anterior knee symptoms after TKA should combine scoring systems to included patellofemoral-related items rather than use patellofemoral scores alone due their ceiling effects.
Level Of Evidence: III; prospective study.
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http://dx.doi.org/10.1016/j.otsr.2022.103292 | DOI Listing |
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 PDFPurpose: To translate and adapt the Norwich Patellar Instability (NPI) score into Norwegian, and second, to examine the psychometric properties of the Norwegian version (NPI-No).
Methods: NPI was translated according to international guidelines. A cohort of 107 patients surgically treated for recurrent patellofemoral instability completed NPI-No, related questionnaires and functional tests prior to and six months post-surgery.
J ISAKOS
January 2025
University of Virginia Health System, Department of Orthopaedic Surgery, Charlottesville, VA, USA.
Purpose: To update previously published clinical and radiographic outcomes of Dejour sulcus-deepening trochleoplasty and medial patellofemoral ligament reconstruction (MPFL-R), at mid-term follow-up, and monitor trends in patient reported outcome scores and satisfaction.
Methods: Using the same cohort of patients from our previously published short-term series of 2-year follow up, interval follow-up was performed on 67 patients (76 knees) with severe trochlear dysplasia and recurrent patellar instability who were prospectively enrolled and underwent Dejour sulcus-deepening trochleoplasty and MPFL-R combined with other patellar-stabilization procedures. Patients with less than 2-year follow-up were excluded.
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.
View Article and Find Full Text PDFBMC Musculoskelet Disord
January 2025
Department of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical University, No.20, Chazhong road, Fuzhou, 350005, China.
Background And Objective: The efficacy of medial unicompartmental knee arthroplasty (UKA) in patients with intraoperatively identified patellofemoral osteoarthritis (PFOA) has been a subject of debate. This retrospective study aimed to investigate the early outcomes of UKA in patients with varying intraoperative PFOA conditions and to explore the relationship between the location of PFOA and the position of the prosthesis post-UKA. Our aim was to determine whether the presence of PFOA affects the short-term success of medial UKA.
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