Subgroups in study seemed well-indicated for patellofemoral joint replacement procedure

Issue: October 2016

At a mean follow-up of 3.2 years, 41 patellofemoral replacement procedures performed in 31 patients were associated with a median Oxford Knee Score of 40 points. Investigators also reported 76% of patients were satisfied and of these, 38% were very satisfied.

The review study involved an assessment of outcomes in a consecutive series of patients who were implanted with the Femoro-Patella Vialla (FPV) prosthesis (Wright Medical) at a single center between November 2007 and November 2011. According to the study, the FPV implant has a broad trochlea and was designed to promote better patellar tracking.

In all, 22 women and nine men with a mean age of 65 years were initially included in the study and treated with the prosthesis for disabling knee pain, which was due to osteoarthritis (OA) in 95% of patients. The reported results did not include one patient who died and one patient who was lost to follow-up.

Results of an analysis of preoperative and postoperative weight-bearing knee radiographs, in which the Ahlback grading system was used, showed no signs of radiographic progression of OA in the tibiofemoral joint in any patients. One patient in the series who had rheumatoid arthritis, however, was converted to total knee replacement (TKR).

Halai and colleagues noted the conclusions were weakened somewhat by a lack of complete preoperative scores for the entire patient cohort, the retrospective design of the study with a small number of patients and the absence of long-term follow-up.

“[Our] early results suggest that the FPV patellofemoral joint replacement is a good alternative to TKR in the surgical management of advanced isolated patellofemoral osteoarthritis. However, we are unable to find a subgroup of patients with superior outcomes, however [we] do not recommend this procedure in patients suffering from rheumatoid arthritis.” – by Susan M. Rapp

Disclosure: The researchers report no relevant financial disclosures.

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Source:

Halai M, et al. World J Orthop. 2016;doi:10.5312/wjo.v7.i8.487