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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

Guangmin Yang
1   Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
,
Jue Wang
2   Department of Internal Medicine, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
,
Yike Dai
1   Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
,
Wei Lin
1   Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
,
Jinghui Niu
1   Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
,
Fei Wang
1   Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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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


Publication History

Received: 03 June 2019

Accepted: 00 June 2020

Article published online:
31 August 2020

© 2020. Thieme. All rights reserved.

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