Patellofemoral Arthroplasty Results Vs. Total Knee Arthroplasty

In this study published this year in Clinical Orthopaedics & Related Research, Anders Odgaard, M.D., et al. at Copenhagen University in Copenhagen, Denmark, (CORR, Vol. 00, No. 00: 1-12), the surgeons wanted to determine if early advantages of resurfacing the kneecaps rather than doing a total knee replacement would deteriorate six years following the operation.  This study was multicenter randomized with 100 patients.  The patellofemoral group lost less motion than the TKA group and, at six years postop follow-up, there was no difference in the risk of requiring a revision or re-operation between the two surgical patient groups. The surgeons concluded that patients who underwent kneecap arthroplasty (PFA) had better knee function than patients who underwent TKA.  There was no greater deterioration in the results up to six years after surgery.  The main indication for the surgery in the first place was severe patellofemoral degenerative arthritis with bone-on-bone contact on the tangential x-ray view without damage occurring at the tibiofemoral joint.  

This data further supports other evidence to suggest that limiting joint replacement in the knee to the portion that is arthritic, not global resurfacing, in patients with isolated severe arthritis is a good choice.  There is less pain, faster recovery, and the patients are of a greater magnitude of satisfaction with less loss of motion.