Patellofemoral Arthroplasty Surgical Technique: Lateral or Medial Parapatellar Approach

被引:10
作者
Jeong, Stacy H. [1 ]
Schneider, Brandon [1 ]
Pyne, Abigail S. [1 ]
Tishelman, Jared C. [1 ]
Strickland, Sabrina M. [1 ]
机构
[1] Hosp Special Surg, Dept Orthopaed Surg, 523 E 72nd St,2nd Floor, New York, NY 10021 USA
关键词
patellofemoral arthroplasty; PFA; osteoarthritis; partial knee arthroplasty; surgical approach; patient-reported outcomes; TOTAL KNEE ARTHROPLASTY; RADIOGRAPHIC PARAMETERS; PATELLA; OSTEONECROSIS; TRACKING; PAIN;
D O I
10.1016/j.arth.2020.04.026
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Patellofemoral arthroplasty (PFA) is an emerging treatment for patients with isolated patellofemoral compartment osteoarthritis. The medial parapatellar approach is the standard arthrotomy but has been shown in total knee arthroplasty to damage the patellar blood supply and increase postoperative patellar instability. The lateral parapatellar approach is an alternative that may reduce the risk of these outcomes. The purpose of this study is to compare the radiographic measures of patellar tracking and patient-reported outcomes of the medial and lateral parapatellar approaches in PFA. Methods: Between 2012 and 2019, a retrospective review was performed of 136 knees undergoing PFA at a single institution. Patients were separated by preoperative congruence angle and then surgical approach into 3 cohorts. Preoperative and postoperative patellar tilt and congruence angle were measured. Preoperative and minimum 6-month postoperative patient-reported outcomes scores were collected. Results: There were no significant differences in the mean postoperative congruence angle and postoperative patient-reported outcomes among the 3 cohorts. Mean postoperative patellar tilt was normalized only in the abnormal congruence angle/lateral approach group to 2.80 degrees (standard error, 1.85). Conclusion: Congruence angle was improved regardless of surgical approach. Patellar tilt was normalized only for the lateral approach in patients with abnormal preoperative congruence angle. There were no significant differences in preoperative and postoperative scores between groups except for preoperative 12-item Short Form Mental Health Survey scores. This study supports that the lateral approach offers improved postoperative patellar tilt compared to a medial approach for PFA while achieving similar patient-reported outcomes. (C) 2020 Elsevier Inc. All rights reserved.
引用
收藏
页码:2429 / 2434
页数:6
相关论文
共 27 条
[1]  
AGLIETTI P, 1983, CLIN ORTHOP RELAT R, P217
[2]  
ARGENSON JNA, 1995, CLIN ORTHOP RELAT R, P162
[3]  
BINDELGLASS DF, 1993, CLIN ORTHOP RELAT R, P103
[4]  
Dejour H., 1994, KNEE SURG SPORTS TRA, V2, P19, DOI DOI 10.1007/BF01552649
[5]  
Gadinsky N., 2017, ANN SPORTS MED RES, V4, P1125
[6]   RADIOGRAPHIC ANALYSIS OF PATELLAR TILT [J].
GRELSAMER, RP ;
BAZOS, AN ;
PROCTOR, CS .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1993, 75 (05) :822-824
[7]   Patellofemoral relationships and cartilage breakdown [J].
Harilainen, A ;
Lindroos, M ;
Sandelin, J ;
Tallroth, K ;
Kujala, UM .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2005, 13 (02) :142-144
[8]  
Holtby RM, 1996, CLIN ORTHOP RELAT R, P155
[9]   The association between patellar alignment and patellogemoral joint osteoarthritis features - an MRI study [J].
Kalichman, L. ;
Zhang, Y. ;
Niu, J. ;
Goggins, J. ;
Gale, D. ;
Felson, D. T. ;
Hunter, D. .
RHEUMATOLOGY, 2007, 46 (08) :1303-1308
[10]  
KEBLISH PA, 1991, CLIN ORTHOP RELAT R, P52