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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2019

01-07-2019 | Arthritis | KNEE

Early outcomes of an anatomic trochlear-cutting patellofemoral arthroplasty: patient selection is key

Authors: David Dejour, Mo Saffarini, Yves Malemo, Marco Pungitore, Jeremy Valluy, Luca Nover, Guillaume Demey

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2019

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Abstract

Purpose

The purpose of this study was to report outcomes of a recent anatomic trochlear-cutting patellofemoral arthroplasty (PFA) system at > 3 years. The hypothesis was that its functional scores and revision rates would be at least equivalent to those reported for other ‘trochlear-cutting’ implants in the literature.

Methods

Twenty-eight consecutive patients that had received PFA using the same anatomic trochlear-cutting implant (KneeTech PFJ, Corin-Tornier, Montbonnot, France) with a dome-shaped patellar button and had systematic lateral facetectomy without lateral release were enrolled. Radiographic parameters collected pre-operatively included: trochlear dysplasia type and patellar height, TT–TG, patellar tilt and shape. Clinical scores collected pre-operatively and at > 3 years included: Oxford Knee Score (OKS) and Knee Society Score (KSS).

Results

The initial cohort comprised 23 women (82%) and five men (18%), aged 63.3 ± 14.7 years, of which 23 had trochlear dysplasia (82%). One patient (4%) could not be reached, and three (11%) were revised to TKA due to arthritic progression, aged 77, 80 and 83 years at index operation, only one of which had trochlear dysplasia (type A). At final follow-up, none of the remaining 24 patients had complications; their OKS was 35.0 ± 10.3 and KSS symptoms and function were 19.8 ± 5.0 and 71.7 ± 13.6.

Conclusion

The anatomic trochlear-cutting PFA granted satisfactory scores and prevented mechanical complications, but the high incidence of early revisions, all due to spread of arthritis hence to improper patient selection. PFA should be restricted to patients with trochlear dysplasia, in whom arthritis was triggered by patellar instability and maltracking rather than degenerative or age-related diseases.

Study design

Retrospective case series, Level IV.
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Metadata
Title
Early outcomes of an anatomic trochlear-cutting patellofemoral arthroplasty: patient selection is key
Authors
David Dejour
Mo Saffarini
Yves Malemo
Marco Pungitore
Jeremy Valluy
Luca Nover
Guillaume Demey
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Keyword
Arthritis
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-019-05368-8

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