Background: The purpose of this study is to evaluate clinical and radiographic outcomes after gender-specific patellofemoral arthroplasty (PFA) either isolated or combined with unicompartmental knee arthroplasty (UKA).
Methods: A total of 105 PFAs in 85 patients were reviewed: 64 knees had isolated patellofemoral osteoarthritis and received an isolated PFA, and 41 knees with bicompartmental osteoarthritis were treated with medial UKA and PFA. Preoperative and postoperative clinical and functional assessment included knee range of motion, Knee Society Score, University of California Los Angeles Activity Score, Tegner Activity Level Scale, and visual analogue scale pain. Preoperative and postoperative radiographs were evaluated for patellofemoral and tibiofemoral compartment osteoarthritis, trochlear dysplasia, changes in patellar height, and signs of osteolysis.
Results: At a mean follow-up of 5.5 ± 1.6 years, both groups showed improvement in knee joint range of motion (P < .001), clinical and functional Knee Society Score (P < .001), University of California Los Angeles Activity Score (P < .001 in the PFA group and P = .004 in the UKA + PFA group), and visual analogue scale pain (P < .001). There were no statistically significant postoperative differences between the 2 groups. No signs of osteolysis or subsidence were recorded. Survivorship of these 105 implants was 95.2%.
Conclusion: Excellent clinical and radiographic outcomes were achieved after PFA with a gender-specific implant both as isolated replacement and when combined with medial UKA. Bicompartmental replacement with small implants can be considered in patients with bicompartmental osteoarthritis and intact anterior cruciate ligament.
Keywords: anterior cruciate ligament sparing surgery; bicompartmental replacement; knee osteoarthritis; knee replacement; patellofemoral osteoarthritis; patellofemoral replacement.
Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.