Evaluation of a minimally aggressive method of patellofemoral osteoarthritis treatment at 10 years minimum follow-up

Background: Knee osteoarthritis mainly affecting the lateral facet of the patella, especially in young patients, is a definite challenge to the surgeon. Our purpose was to investigate the long-term outcome of a simple operation such as the partial lateral facetectomy on middle-aged to elderly patients with predominant lateral patellofemoral osteoarthritis. Methods: A retrospective, long-term study of 39 knees (28 females, mean aged at surgery 61 years old) with a minimum follow-up of 10 years was performed. Evaluations included preoperative and postoperative questionnaires, physical examinations, and radiographs. Results: The main outcomes included the initial anterior pain relief, with higher scores using the Knee Society Score (that improved in 84% of the knees), and the eventual failure of the technique, including percentage of patients that required secondary total knee replacement (30% of the knees). Conclusion: Partial lateral facetectomy aiming to decrease the high pressure in the lateral facet of the patella confirmed frequent pain relief. This surgical procedure being minimally invasive, relatively simple, and effective in selected patients, is a valid early alternative to more complex operations and does not preclude further reconstructive surgery in case of disease progression. (C) 2013 Elsevier B.V. All rights reserved.