TY - JOUR
T1 - The lack of retropatellar resurfacing at index surgery is significantly associated with failure in patients following patellofemoral inlay arthroplasty
T2 - a multi-center study of more than 260 patients
AU - Imhoff, Andreas B.
AU - Bartsch, Eva
AU - Becher, Christoph
AU - Behrens, Peter
AU - Bode, Gerrit
AU - Cotic, Matthias
AU - Diermeier, Theresa
AU - Falk, Holger
AU - Feucht, Matthias J.
AU - Haupt, Ulrich
AU - Hinterwimmer, Stefan
AU - Holz, Johannes
AU - Hutter, René
AU - Kaiser, René
AU - Knoblauch, Tobias
AU - Nebelung, Wolfgang
AU - Niemeyer, Philipp
AU - O’Donnel, Turlough
AU - Pagenstert, Geert
AU - Patzer, Thilo
AU - Rose, Tim
AU - Rupp, Marco C.
AU - Tischer, Thomas
AU - Venjakob, Arne J.
AU - Vogt, Stephan
AU - Pogorzelski, Jonas
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2022/4
Y1 - 2022/4
N2 - Purpose: To evaluate the clinical outcomes of patients with a minimum 2-year follow-up following contemporary patellofemoral inlay arthroplasty (PFIA) and to identify potential risk factors for failure in a multi-center study. Methods: All patients who underwent implantation of PFIA between 09/2009 and 11/2016 at 11 specialized orthopedic referral centers were enrolled in the study and were evaluated retrospectively at a minimum 2-year follow-up. Clinical outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tegner Scale, the visual analogue scale (VAS) for pain, and subjective patient satisfaction. Pre- and perioperative risk factors were compared among failures and non-failures to determine potential risk factors. Results: A total of 263 patients (85% follow-up rate) could be enrolled. The mean age at the time of index surgery was 49 ± 12 years with a mean postoperative follow-up of 45 ± 18 months. The overall failure rate was 11% (28 patients), of which 18% (5 patients) were patients with patella resurfacing at index surgery and 82% (23 patients) were patients without initial patella resurfacing. At final follow-up, 93% of the patients who did not fail were satisfied with the procedure with a mean transformed WOMAC Score of 84.5 ± 14.5 points, a mean KOOS Score of 73.3 ± 17.1 points, a mean Tegner Score of 3.4 ± 1.4 points and a mean VAS pain of 2.4 ± 2.0 points. An increased BMI was significantly correlated with a worse postoperative outcome. Concomitant procedures addressing patellofemoral instability or malalignment, the lack of patellofemoral resurfacing at the index surgery and a high BMI were significantly correlated with failure in our patient cohort. Conclusion: Patellofemoral inlay arthroplasty shows high patient satisfaction with good functional outcomes at short-term follow-up and thus can be considered a viable treatment option in young patients suffering from isolated patellofemoral arthritis. Patellar resurfacing at index surgery is recommended to decrease the risk of failure. Level of evidence: Retrospective case series, Level IV.
AB - Purpose: To evaluate the clinical outcomes of patients with a minimum 2-year follow-up following contemporary patellofemoral inlay arthroplasty (PFIA) and to identify potential risk factors for failure in a multi-center study. Methods: All patients who underwent implantation of PFIA between 09/2009 and 11/2016 at 11 specialized orthopedic referral centers were enrolled in the study and were evaluated retrospectively at a minimum 2-year follow-up. Clinical outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tegner Scale, the visual analogue scale (VAS) for pain, and subjective patient satisfaction. Pre- and perioperative risk factors were compared among failures and non-failures to determine potential risk factors. Results: A total of 263 patients (85% follow-up rate) could be enrolled. The mean age at the time of index surgery was 49 ± 12 years with a mean postoperative follow-up of 45 ± 18 months. The overall failure rate was 11% (28 patients), of which 18% (5 patients) were patients with patella resurfacing at index surgery and 82% (23 patients) were patients without initial patella resurfacing. At final follow-up, 93% of the patients who did not fail were satisfied with the procedure with a mean transformed WOMAC Score of 84.5 ± 14.5 points, a mean KOOS Score of 73.3 ± 17.1 points, a mean Tegner Score of 3.4 ± 1.4 points and a mean VAS pain of 2.4 ± 2.0 points. An increased BMI was significantly correlated with a worse postoperative outcome. Concomitant procedures addressing patellofemoral instability or malalignment, the lack of patellofemoral resurfacing at the index surgery and a high BMI were significantly correlated with failure in our patient cohort. Conclusion: Patellofemoral inlay arthroplasty shows high patient satisfaction with good functional outcomes at short-term follow-up and thus can be considered a viable treatment option in young patients suffering from isolated patellofemoral arthritis. Patellar resurfacing at index surgery is recommended to decrease the risk of failure. Level of evidence: Retrospective case series, Level IV.
KW - Inlay
KW - Knee
KW - Patellofemoral
KW - Patellofemoral arthroplasty
KW - Patellofemoral osteoarthritis
KW - Patellofemoral resurfacing
KW - Retropatellar resurfacing
KW - Trochlea
KW - WAVE prosthesis
UR - http://www.scopus.com/inward/record.url?scp=85103660619&partnerID=8YFLogxK
U2 - 10.1007/s00167-021-06544-5
DO - 10.1007/s00167-021-06544-5
M3 - Article
C2 - 33811265
AN - SCOPUS:85103660619
SN - 0942-2056
VL - 30
SP - 1212
EP - 1219
JO - Knee Surgery, Sports Traumatology, Arthroscopy
JF - Knee Surgery, Sports Traumatology, Arthroscopy
IS - 4
ER -