Patella alta and patellar subluxation might lead to early failure with inlay patello-femoral joint arthroplasty

Purpose With the growing interest in resurfacing procedures, several new implants have been recently introduced for isolated patello-femoral joint arthroplasty (PFA). However, not much data are available for these new techniques or about the right indications for each type of implant. Methods Out of...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2019-03, Vol.27 (3), p.685-691
Main Authors: Beckmann, J., Merz, C., Huth, J., Rath, B., Schnurr, C., Thienpont, E.
Format: Article
Language:English
Subjects:
Abrasion
Arthritis
Arthroplasty
Biomedical materials
Failure analysis
Femur
Joint surgery
Knee
Medicine
Medicine & Public Health
Orthopedics
Pain
Patella
Resurfacing
Surfacing
Surgical implants
Transplants & implants
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Summary:Purpose With the growing interest in resurfacing procedures, several new implants have been recently introduced for isolated patello-femoral joint arthroplasty (PFA). However, not much data are available for these new techniques or about the right indications for each type of implant. Methods Out of a retrospective cohort of 20 inlay PFA, 11 PFA with an elevated Insall–Salvati index and an increased patello-femoral congruence angle showed an initial satisfactory result, but presented thereafter with recurrent pain and “clunk” phenomena. They were all revised after a median time of 25 months (range 8–28 months) into an onlay technique PFA and analyzed for their failure mode and revision technique. Results Clinical symptoms such as clunking, as well as abraded areas craniolateral of the inlay implant found intraoperatively, were the main observations of this study. The modified Insall–Salvati index (mISI) was significantly higher in the revised knees compared to the unrevised (median 1.8 versus 1.6; p  = 0.041). VAS and KSS significantly improved after revision (median VAS reduction in pain of 4.0 points, median KSS improvement of 20.0 points; p  
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-018-4965-8