Patellofemoraler Gelenkersatz : Wo stehen wir heute?
(2020) Arthroskopie — Vol. 33, n° 4, p. 275-281 (2020)
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- (en) [Patellofemoral joint arthroplasty : What is the current situation?] In recent years the philosophy of pathology-based repair of damage while preserving healthy structures has become increasingly prevalent in the field of endoprosthetics. Therefore, patellofemoral joint arthroplasty (PFA) seems to be a logical treatment option for advanced isolated patellofemoral arthrosis; however, the results of PFA are controversially discussed in the literature, so that some orthopedic surgeons prefer total knee arthroplasty (TKA); however, especially in young patients, this can be considered as overkill, since important structures are sacrificed. The preference of a total endoprosthesis over PFA is mainly due to the high revision rates, which can be found especially in older generation implant designs. Various factors that can contribute to a high revision rate must be taken into account. Despite the frequent incidence of almost 10% in the population over 40 years old, PFA is a rarely performed operation. This low number of cases per surgeon results in a flat learning curve and leads to a reduced experience of the surgeon. Furthermore, the revision threshold for PFA is lower compared to primary TKA. For a successful outcome of PFA the implant design but particularly the correct alignment and the correct indications are crucial. Before each PFA implantation, potential causative deformities should be identified and treated if necessary. In the presence of additional advanced degenerative changes of the tibiofemoral compartments, instability or severe leg axis deviations, the endoprosthetics should be extended to also include parts of the tibiofemoral joint.
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Beckmann, J., Meier, M., Halder, A., Best, R., Thienpont, E., & Beier, A. (2020). Patellofemoraler Gelenkersatz : Wo stehen wir heute? Arthroskopie, 33(4), 275-281. https://doi.org/10.1007/s00142-020-00375-1 (Original work published 2020)