Patellofemoral arthritis

BACKGROUND: High tibial osteotomy is an established surgical option for medial compartment osteoarthritis of the knee with varus alignment. It can be divided into open wedge and closing wedge by operative technique. Although they have fundamental differences, little is known about the biomechanical consequences of the two surgical methods. METHODS: Thirty-eight patients with medial compartment osteoarthritis who underwent high tibial osteotomy (19 open-wedge and 19 closing-wedge) were retrospectively reviewed...

PURPOSE: The aim of this study was to evaluate patellar mobility in patients before and after knee arthroplasty (KA) and compare it with that of healthy subjects. It was hypothesised that patellar mobility is diminished in patients with osteoarthritis (OA) and remains unchanged after KA. METHODS: A total of 101 patients (59 females and 42 males) with a mean age of 70.9 ± 9.9 years underwent KA and were compared with 25 healthy individuals (seven females and 18 males) with a mean age of 32...

OBJECTIVE: A rotational osteotomy requires a complete cut of the bone in order to correct maltorsion. An additional correction of the frontal axis can be achieved via an oblique cut of the bone. The osteotomy with bone to bone contact is fixed with an angle stable plate. INDICATIONS: Symptoms such as anterior knee pain, inwardly pointing knee syndrome, lateral patellar subluxation or dislocation, lateral patellar hypercompression syndrome are a common indication for derivational osteotomy if clinically increased femoral internal rotation and radiologically increased femoral antetorsion is detected...

PURPOSE: The aims of the present study were (1) to evaluate the survival of patellofemoral joint (PFJ) arthroplasty in a large cohort of patients using data obtained from an Italian regional arthroplasty registry and (2) to collect clinical outcomes of a subgroup of patients, with a minimum follow-up of 4 years. The hypotheses were that PFJ arthroplasty is a procedure that had good survival and clinical outcomes, not inferior to those reported in the literature for primary total knee arthroplasty (TKA)...

BACKGROUND: Partial knee replacement has proven to be an effective therapy for advanced unicompartmental arthrosis of the knee. Despite continuous advancements in implants and surgical techniques over the past decades, the global preference for total knee arthroplasty still persists for historical reasons. OBJECTIVES: This report aims to illuminate advantages and disadvantages of partial knee replacement considering long-term results, the evolution of indication criteria over recent decades and new aspects in patient selection with potential improvements through emerging technologies...

INTRODUCTION: Patellofemoral arthroplasty (PFA) has been shown to provide symptomatic improvement for isolated patellofemoral osteoarthritis (PFOA). The efficacy of robotic-assisted PFA and the most suitable PFA implant design, however, remain ongoing matters of debate. This study sought to compare clinical outcomes between patients who underwent robotic-assisted versus conventional PFAs with inlay and onlay prosthetic designs. METHODS: A single-center retrospective review found 237 knees (211 patients) which underwent PFA between 2011 and 2021...

BACKGROUND: Patellofemoral arthroplasty (PFA) is a treatment option for isolated patellofemoral arthritis. Custom PFA is an innovative procedure utilizing patient-specific instrumentation. The purpose of this study is to evaluate short-term functional outcomes and complications of the custom PFA in treatment of isolated patellofemoral arthritis. METHODS: A retrospective study was conducted to analyze patients who received a PFA operation from a single surgeon. Inclusion criteria were surgical patients from 2012 to 2018 who underwent PFA using a custom prosthesis implant...

PURPOSE: The purpose of the study was to report the clinical, functional and radiological outcome following varus osteotomy as a salvage procedure in young to middle-aged patients with patellofemoral arthritis (PFA) and associated valgus malalignment. It was hypothesized that a significant improvement in knee function and reduction in pain would be achieved. Moreover, no conversion to patellofemoral joint arthroplasty could be observed. MATERIAL AND METHODS: Patients (< 50 years of age) that underwent varus osteotomy between 08/2012 and 01/2020 for the treatment of symptomatic PFA and associated valgus malalignment were consecutively included (minimum follow-up: 24 months)...

BACKGROUND: In-toeing gait is defined as the internal rotation of the long axis of the foot to the line of progression. Although most of the time it is corrected spontaneously but sometimes causes torsional misalignment syndrome and maybe patellofemoral instability and arthritis of the knee. RESEARCH QUESTION: What is the effect of gait plate insoles and lateral sole wedged shoes on foot progression angle (FPA) in children with in-toeing? METHOD: In this study, a randomized control trial was conducted with 11 participants (18 feet) who were girls aged between seven and ten years old...

Unicompartmental knee arthroplasty (UKA), a procedure that has gradually emerged in recent years, is considered an effective treatment for resolving knee pain and restoring good function due to its significant clinical advantages. In the 1980s, Kozinn and Scott proposed the classic indications as selection criteria to identify ideal candidates for UKA. However, as treatment concepts, surgical instruments, surgical techniques, and prosthesis designs for this disease have improved, these indications proposed more than 30 years ago appear too limited, leading to some limitations in the widespread use of UKA...

Spontaneous tendon or ligament ruptures are quite rare and mostly associated with chronic systemic diseases such as diabetes mellitus, systemic lupus erythematosus, rheumatoid arthritis, and chronic kidney disease (CKD). In this study, we present the first documented case of a spontaneous rupture of the medial patellofemoral ligament (MPFL) in a pediatric patient. The patient was undergoing long-term peritoneal dialysis (PD) and had a history of severe secondary hyperparathyroidism. Additionally, we discussed spontaneous tendon and ligament ruptures associated with CKD or dialysis through a comprehensive literature review...

AIMS: With up to 40% of patients having patellofemoral joint osteoarthritis (PFJ OA), the two arthroplasty options are to replace solely the patellofemoral joint via patellofemoral arthroplasty (PFA), or the entire knee via total knee arthroplasty (TKA). The aim of this study was to assess postoperative success of second-generation PFAs compared to TKAs for patients treated for PFJ OA using patient-reported outcome measures (PROMs) and domains deemed important by patients following a patient and public involvement meeting...

BACKGROUND: Recurrent lateral patellar dislocation (RLPD) poses a significant threat to patients' quality of life due to knee pain, patellofemoral cartilage damage, and potential traumatic arthritis. Predictive scoring systems have been developed to assess the risk of RLPD; however, their relative accuracy remains uncertain. PURPOSE: To investigate the accuracy of the multiple regression models to predict the individual risk of recurrent LPD. METHODS: The Patellar Instability probability calculator (PIP), Recurrent Instability of the Patella Score (RIP), and Patellar Instability Severity Score (PIS) scoring rules were measured in 171 patients with a history of patellar dislocation and 171 healthy individuals...

Successful patellofemoral arthroplasty (PFA) requires appropriate patient selection, correct implant positioning and attention to surgical technique. Whilst the original concept and rationale offered an attractive surgical option for patients with isolated patellofemoral arthritis, early results were disappointing and consequently many surgeons became reluctant to offer it. With newer generation design, outcomes have been more promising. However, attention to surgical technique remains an integral component to a successful outcome, with results being unforgiving when surgical errors are made...

INTRODUCTION: Patellofemoral joint arthroplasty (PFJA) is mainly used to treat older patients suffering from osteoarthritis. However, this case report sheds light on the implications of this treatment for young patients suffering from patellar maltracking and secondary patellofemoral osteoarthritis (PFOA). CASE REPORT: A female patient in her late 3rd decade of life presented with long-standing bilateral knee pain and significant functional impairment, including difficulty walking and stair climbing...

One of the contraindications to patella resurfacing in total knee arthroplasty is a thin and severely eroded 'deficient' patella. However, such patients often present with severe patellofemoral joint arthritis, patellar lateral subluxation, and patella maltracking, which can only be treated effectively with resurfacing. While various treatments have been proposed, options remain limited. Here we introduce a method of patella reconstruction using four 2.7-mm titanium cortical screws crossing each other into the inner shell of the patella...

The aim of this study was to investigate clinical and instrumental outcomes of the autologous matrix-induced chondrogenesis (AMIC) technique for the treatment of isolated traumatic condyle and femoropatellar cartilage lesions. A total of 25 patients (12 males, 13 females, mean age 47.3 years) treated between 2018 and 2021 were retrospectively reviewed and subdivided into two groups based on age (Group A, age < 45 years; Group B, age > 45 years). A clinical evaluation was performed using the International Knee Documentation Committee (IKDC), Lysholm score and Visual Analogue Score (VAS)...

Patellofemoral (PFJ) arthritis can be primary, or secondary to underlying trochlea dysplasia and patellofemoral malalignment. Although primary PFJ osteoarthritis affects an older patient population, just like tibiofemoral arthritis, it is common for younger patients to present with isolated PFJ arthritis secondary to an abnormal PFJ. PFJ arthroplasty (PFJA) has many benefits including being less invasive, associated with lower blood loss, is more cost-effective, and leaves the kinematics of the tibiofemoral joint undisturbed...

BACKGROUND: Developmental dysplasia of the hip (DDH) and trochlear dysplasia (TD) are distinct pathologies with several important features in common. In addition to shared risk factors, both forms of dysplasia cause abnormal joint kinematics and force transmission, predisposing patients to pain, injuries to cartilage and soft tissue stabilizers, and ultimately arthritis. PURPOSE: To evaluate for an association between hip dysplasia and TD in skeletally mature patients with symptomatic hip dysplasia...

OBJECTIVE: Anterior knee pain (AKP) is associated with patellofemoral osteoarthritis (PFOA), but longitudinal studies are lacking. If AKP precedes PFOA, it may create an opportunity to identify and intervene earlier in the disease process. The purpose of this study was to examine the longitudinal relation of AKP to worsening PF cartilage over two years. DESIGN: Participants were recruited from the Multicenter Osteoarthritis Study (MOST), a longitudinal study of individuals with or at-risk for knee OA...