Abstract
Patellofemoral arthroplasty (PFA) has garnered attention in recent years as an effective
alternative to total knee arthroplasty for patients with symptomatic, isolated patellofemoral
joint arthritis. Obesity has previously been identified as a risk factor for revision
surgery, but its effect on patient-reported outcome measures (PROMs) has not been
evaluated. A retrospective review of a consecutive series of PFA surgeries was conducted at
a single, specialized orthopedics center in a major urban center. Patients were dichotomized
by body mass index (BMI) as obese (O, BMI >30) or nonobese (NO, BMI: 18.5–25). Demographic,
surgical information, and PROMs were collected and analyzed accordingly. Seventy-six
patients (41 nonobese, 35 obese) were identified. Patients who were obese presented
with significantly worse preoperative PROMs regarding knee-specific quality of life,
physical function, and MH or mental health (knee injury and osteoarthritis outcome
score quality of life [KOOS QoL], NO: 26.2, O: 14.7, p = 0.019; KOOS PF, NO: 38.2, O: 50.5, p = 0.002; Veterans Rand-12 mental health [VR-12 MH], NO: 54.2, O: 47.0, p = 0.033). No significant difference was seen in improvement in knee function scores
between patients who were obese or nonobese (KOOS QoL, NO: 39.5, O: 40.6, p = 0.898; KOOS PS [physical function], NO: –17.8, O: –17.3, p = 0.945). Additionally, no difference in the rate of PFA revision was observed and
there were no postoperative complications reported. Obese patients with isolated PFA
can expect the same improvement in function as nonobese patients following patellofemoral
joint arthroplasty. This paper underscores the priority of patient selection in PFA
and challenges the notion that surgeons should exclude patients from receiving a PFA
on the basis of obesity.
Keywords
patient-reported outcomes - patellofemoral arthroplasty - obesity
