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TKA more durable than patellofemoral arthroplasty as treatment for isolated patellofemoral arthritis
SAN FRANCISCO — The reliable clinical results of total knee arthroplasty make it the treatment of choice for patients with patellofemoral arthritis, according to a a presenter at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting, here.
“I believe there is good literature support for total knee replacements in patellofemoral arthritis, broad surgical indications, low complication rates and [it is] quite durable,” Michael A. Kelly, MD, said.
“Historically patellofemoral arthroplasty (PFA) has issues of implant design, increased complication rates requiring secondary soft tissue procedures, and long-term failures for progressive arthritis.”
Kelly, of Hackensack, N.J., noted, by comparison, that total knee arthroplasty (TKA) has notoriously been associated with fewer secondary surgical procedures and a lower incidence of progressive patellofemoral joint disease, reviewing some published results to support his case.
Although early designs of PFA prostheses were problematic, he acknowledged that newer ones have solved some previous problems. Furthermore, “Early complication rates have certainly improved in the past decade, but these are very dependent on proper patient selection,” Kelly said.
Reference:
- Kelly MA. TKA versus patellofemoral arthroplasty for isolated patellofemoral arthritis – TKA. Symposium C: Controversies in primary total knee arthroplasty. Presented at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting. Feb. 7-11. San Francisco.
- Disclosure: Kelly receives royalties from Zimmer, is a paid consultant to RTI Biologics and Zimmer, and has stock or stock options with Pfizer.
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