Scientific evidence for the use of modern patellofemoral arthroplasty

Abstract

Patellofemoral arthroplasty has been utilized as a treatment for isolated patellofemoral arthritis for more than 30 years. However, the use of this procedure remains controversial, as many surgeons prefer to use total knee arthroplasty, even for isolated patellofemoral arthritis. While historically, the results with this procedure have been inconsistent, recent developments in prosthesis design and surgical indications have improved the outcomes of patellofemoral arthroplasty. Potential advantages of patellofemoral arthroplasty include a less invasive approach, less bone resection, less tissue destruction, shorter operative time, less blood loss, shorter rehabilitation, and more normal knee kinematics. However, proper indications and surgical technique are crucial in order to obtain optimal results. Some future modifications have the potential to further improve the outcomes of the procedure, although additional investigations are needed to further explore some of these aspects. This report will describe current knowledge regarding the indications and contraindications for patellofemoral arthroplasty, present the results and complications of this procedure, discuss alternative treatments for patellofemoral disease, and explore future directions for arthroplasty of the patellofemoral compartment.

Keywords::

• bicompartmental arthroplasty
• dysplasia
• knee
• patella baja
• patellofemoral arthroplasty
• tibial tubercle osteotomy
• total knee arthroplasty

Financial & competing interests disclosure

Michael A Mont is a paid consultant for Styker Orthopaedics and Wright Medical Technologies, receives royalties from Stryker Orthopaedics, and has received institutional or research support from Stryker Orthopaedics, Wright Medical Technologies, Biomet, BrainLab, DePuy, Finsbury, Smith and Nephew and Salient Surgical Technologies.

Peter Bonutti is a paid consultant for Stryker Orthopaedics, is part of a speakers bureau for Stryker Orthopaedics, is a board member/owner of Joint Active Systems and Unity Ultrasonic Fixation, and receives royalties from Styker Orthopaedics, Arthrocare and Biomet.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

Modified with permission from [14].