Patellofemoral Arthroplasty Improves Patellofemoral Alignment in Patients with Patellofemoral Osteoarthritis with Trochlear Dysplasia

Guangmin Yang; Jue Wang; Yike Dai; Wei Lin; Jinghui Niu; Fei Wang

doi:10.1055/s-0040-1715099

The Journal of Knee Surgery, Inhaltsverzeichnis

J Knee Surg 2022; 35(03): 331-336
DOI: 10.1055/s-0040-1715099

Original Article

Patellofemoral Arthroplasty Improves Patellofemoral Alignment in Patients with Patellofemoral Osteoarthritis with Trochlear Dysplasia

Authors

Guangmin Yang

¹Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
Jue Wang

²Department of Internal Medicine, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
Yike Dai

¹Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
Wei Lin

¹Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
Jinghui Niu

¹Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
Fei Wang

¹Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China

Abstract

The impact of trochlear dysplasia on patellofemoral arthroplasty (PFA) has rarely been reported in the literature. The purpose of this study was to explore the effectiveness of PFA in patients with patellofemoral osteoarthritis (PFOA) associated with trochlear dysplasia. From January 2014 to March 2018, 35 patients with PFOA and trochlear dysplasia (29 females and 6 males), underwent PFA, were included in the present retrospective study. Radiological measurements including the patellar tilt (PT), congruence angle (CA), Blackburne–Peel ratio (BPR), tibial tuberosity–trochlear groove (TT–TG) distance, and lateral trochlear inclination (LTI) were assessed pre- and postoperatively to evaluate the changes in patellofemoral alignment. The patient-reported functional outcome was assessed using the Oxford Knee Score. The mean follow-up time was 24 months (range, 18–42 months). The intraclass correlation coefficients were excellent for all measurements. The patellofemoral alignment and knee function were significantly improved postoperatively. The PT decreased from 23.3 ± 6.3 degrees preoperatively to 6.4 ± 2.3 degrees postoperatively (p < 0.001). The CA decreased from 32.3 ± 8.6 degrees preoperatively to 10.2 ± 3.6 degrees postoperatively (p < 0.001). The lateral trochlear inclination increased from 8.3 ± 4.1 degrees preoperatively to 16.0 ± 1.2 degrees postoperatively (p < 0.001). The TT–TG distance decreased from 18.2 ± 3.8 mm preoperatively to 11.5 ± 3.3 mm postoperatively (p < 0.001). The BPR did not significantly change postoperatively (p = 0.390). The average Oxford Knee Score improved from 19.5 preoperatively to 29.2 at 6 months postoperatively (p < 0.001), 37.9 at 1 year postoperatively (p < 0.001), and 39.1 at final follow-up (p < 0.001). No patient developed patellofemoral malalignment or prosthesis loosening during short-term follow-up. PFA achieved favorable therapeutic results in patients with PFOA associated with trochlear dysplasia.

Keywords

patellofemoral osteoarthritis - patellofemoral arthroplasty - trochlear dysplasia - alignments - knee

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Referenzen

References
1 Cuthbert R, Tibrewal S, Tibrewal SB. Patellofemoral arthroplasty: Current concepts. J Clin Orthop Trauma 2018; 9 (01) 24-28
2 Jungmann PM, Tham SC, Liebl H. et al. Association of trochlear dysplasia with degenerative abnormalities in the knee: data from the osteoarthritis initiative. Skeletal Radiol 2013; 42 (10) 1383-1392
3 Mofidi A, Veravalli K, Jinnah RH, Poehling GG. Association and impact of patellofemoral dysplasia on patellofemoral arthropathy and arthroplasty. Knee 2014; 21 (02) 509-513
4 Valoroso M, Saffarini M, La Barbera G. et al. Correction of patellofemoral malalignment with patellofemoral arthroplasty. J Arthroplasty 2017; 32 (12) 3598-3602
5 Saffarini M, Ntagiopoulos PG, Demey G, Le Negaret B, Dejour DH. Evidence of trochlear dysplasia in patellofemoral arthroplasty designs. Knee Surg Sports Traumatol Arthrosc 2014; 22 (10) 2574-2581
6 Lonner JH. Patellofemoral arthroplasty: pros, cons, and design considerations. Clin Orthop Relat Res 2004; (428) 158-165
7 Suzuki T, Hosseini A, Li JS, Gill IV TJ, Li G. In vivo patellar tracking and patellofemoral cartilage contacts during dynamic stair ascending. J Biomech 2012; 45 (14) 2432-2437
8 Argenson JN, Flecher X, Parratte S, Aubaniac JM. Patellofemoral arthroplasty: an update. Clin Orthop Relat Res 2005; 440 (440) 50-53
9 Dy CJ, Franco N, Ma Y, Mazumdar M, McCarthy MM, Gonzalez Della Valle A. Complications after patello-femoral versus total knee replacement in the treatment of isolated patello-femoral osteoarthritis. A meta-analysis. Knee Surg Sports Traumatol Arthrosc 2012; 20 (11) 2174-2190
10 Merchant AC. A modular prosthesis for patellofemoral arthroplasty: design and initial results. Clin Orthop Relat Res 2005; (436) 40-46
11 Dahm DL, Kalisvaart MM, Stuart MJ, Slettedahl SW. Patellofemoral arthroplasty: outcomes and factors associated with early progression of tibiofemoral arthritis. Knee Surg Sports Traumatol Arthrosc 2014; 22 (10) 2554-2559
12 Middleton SWF, Toms AD, Schranz PJ, Mandalia VI. Mid-term survivorship and clinical outcomes of the Avon patellofemoral joint replacement. Knee 2018; 25 (02) 323-328
13 Mont MA, Johnson AJ, Naziri Q, Kolisek FR, Leadbetter WB. Patellofemoral arthroplasty: 7-year mean follow-up. J Arthroplasty 2012; 27 (03) 358-361
14 van der List JP, Chawla H, Zuiderbaan HA, Pearle AD. Survivorship and functional outcomes of patellofemoral arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc 2017; 25 (08) 2622-2631
15 Ahearn N, Metcalfe AJ, Hassaballa MA. et al. The Journey patellofemoral joint arthroplasty: a minimum 5year follow-up study. Knee 2016; 23 (05) 900-904
16 Brandt KD, Fife RS, Braunstein EM, Katz B. Radiographic grading of the severity of knee osteoarthritis: relation of the Kellgren and Lawrence grade to a grade based on joint space narrowing, and correlation with arthroscopic evidence of articular cartilage degeneration. Arthritis Rheum 1991; 34 (11) 1381-1386
17 Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 1994; 2 (01) 19-26
18 Dejour H, Walch G, Neyret P, Adeleine P. [Dysplasia of the femoral trochlea] (in French). Rev Chir Orthop Repar Appar Mot 1990; 76 (01) 45-54
19 Goutallier D, Bernageau J, Lecudonnec B. [The measurement of the tibial tuberosity. Patella groove distanced technique and results (author's transl)] (in French). Rev Chir Orthop Repar Appar Mot 1978; 64 (05) 423-428
20 Merchant AC, Mercer RL, Jacobsen RH, Cool CR. Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg Am 1974; 56 (07) 1391-1396
21 Urch SE, Tritle BA, Shelbourne KD, Gray T. Axial linear patellar displacement: a new measurement of patellofemoral congruence. Am J Sports Med 2009; 37 (05) 970-973
22 Schoettle PB, Zanetti M, Seifert B, Pfirrmann CW, Fucentese SF, Romero J. The tibial tuberosity-trochlear groove distance; a comparative study between CT and MRI scanning. Knee 2006; 13 (01) 26-31
23 Carrillon Y, Abidi H, Dejour D, Fantino O, Moyen B, Tran-Minh VA. Patellar instability: assessment on MR images by measuring the lateral trochlear inclination-initial experience. Radiology 2000; 216 (02) 582-585
24 Murray DW, Fitzpatrick R, Rogers K. et al. The use of the Oxford hip and knee scores. J Bone Joint Surg Br 2007; 89 (08) 1010-1014
25 Osarumwense D, Syed F, Nzeako O, Akilapa S, Zubair O, Waite J. Patellofemoral joint arthroplasty: early results and functional outcome of the Zimmer Gender Solutions patello-femoral joint system. Clin Orthop Surg 2017; 9 (03) 295-302
26 Wang CH, Ma LF, Zhou JW. et al. Double-bundle anatomical versus single-bundle isometric medial patellofemoral ligament reconstruction for patellar dislocation. Int Orthop 2013; 37 (04) 617-624
27 Christ AB, Baral E, Koch C, Shubin Stein BE, Gonzalez Della Valle A, Strickland SM. Patellofemoral arthroplasty conversion to total knee arthroplasty: retrieval analysis and clinical correlation. Knee 2017; 24 (05) 1233-1239
28 van der List JP, Chawla H, Villa JC, Pearle AD. Why do patellofemoral arthroplasties fail today? A systematic review. Knee 2017; 24 (01) 2-8
29 Hernigou P, Caton J. Design, operative technique and ten-year results of the Hermes patellofemoral arthroplasty. Int Orthop 2014; 38 (02) 437-442
30 Nicol SG, Loveridge JM, Weale AE, Ackroyd CE, Newman JH. Arthritis progression after patellofemoral joint replacement. Knee 2006; 13 (04) 290-295
31 Odgaard A, Madsen F, Kristensen PW, Kappel A, Fabrin J. The Mark coventry award: patellofemoral arthroplasty results in better range of movement and early patient-reported outcomes than TKA. Clin Orthop Relat Res 2018; 476 (01) 87-100
32 Ackroyd CE, Chir B. Development and early results of a new patellofemoral arthroplasty. Clin Orthop Relat Res 2005; (436) 7-13