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J Knee Surg 2023; 36(04): 382-388
DOI: 10.1055/s-0041-1735159
Original Article

Patient-Reported Outcomes and Risk Factors for Decreased Improvement after Patellofemoral Arthroplasty

Yike Dai
1   Department of Orthopaedic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
,
Naicheng Diao
1   Department of Orthopaedic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
,
Wei Lin
2   Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
,
Guangmin Yang
2   Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
,
Huijun Kang
2   Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
,
Fei Wang
2   Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
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Abstract

Patellofemoral arthroplasty (PFA) is acknowledged as the method for the treatment of isolated patellofemoral osteoarthritis (PFOA). Few previous studies have assessed the patient-reported outcomes (PROs) and risk factors of less improvement of PROs in patients undergoing PFA. A retrospective analysis was performed, including all patients who had undergone PFA. Pre- and postoperative PROs included the Oxford Knee Score (OKS) and Kujala score. Univariate and multivariate statistical analyses were performed to assess influencing factors of less improvement of PROs including the demographic factors (gender, age, body mass index, smoking, opioid usage, and duration of symptoms [DOSs]), surgical factors (concomitant surgery), and imaging factors (trochlear dysplasia [TD], patellar height, the degree of PFOA). A total of 46 PFAs were analyzed with a mean follow-up of 37 ± 7 months. The mean age at surgery was 61.1 ± 7.7 years. Patients showed significant improvement in all PROs (p < 0.001). Patients with TD preoperatively have greater improvement in OKS and Kujala score postoperatively (19.2 ± 5.0 vs. 23.1 ± 3.6, p = 0.038). Longer DOSs (≥1 year) had a greater mean improvement in OKS and Kujala score (p = 0.011 and p = 0.000). According to the measurement of patella height, patients with patella alta (Caton–Deschamps index [CDI] ≥1.3) showed less improvement in both OKS and Kujala score (p = 0.000 and p = 0.002). PFA is a safe and efficient surgery with good PROs. Patella alta with a CDI ≥1.3 and duration of preoperative symptoms ≤ 1 year were risk factors for decreased OKS and Kujala score improvement, while the preoperative presence of TD was significantly predictive factors for increased OKS improvement.

Keywords

patellofemoral arthroplasty - Kujala score - Oxford Knee Score


Publication History

Received: 08 January 2021

Accepted: 22 July 2021

Article published online:
28 September 2021

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