Background: The treatment of isolated patellofemoral arthritis is
controversial. Several surgical procedures have been used to treat the
severely degenerated patellofemoral joint, with varying degrees of success.
The purpose of this study was to determine the clinical results of a custom
patellofemoral arthroplasty for the treatment of isolated patellofemoral
degenerative arthritis of the knee.
Methods: From 1995 through 2002, twenty-five patellofemoral
replacements, three of which were bilateral, were performed in twenty-two
patients for the treatment of isolated patellofemoral arthritis of the knee.
According to the Ahlback radiographic evaluation scale, the mean preoperative
score for the severity of the arthritis was 4.65 points in the patellofemoral
compartment and 0.5 point in both the medial and the lateral compartment. The
patients included sixteen women (two of whom had a bilateral replacement) and
six men (one of whom had a bilateral replacement) with a mean age of
forty-five years at the time of the index arthroplasty. Seventeen patients
(nineteen knees) had had a prior procedure on the knee. The mean preoperative
Knee Society functional score was 49 points, and the mean preoperative Knee
Society objective score was 52 points.
Results: At a mean of seventy-three months (range, thirty-two to 119
months) postoperatively, all twenty-five implants were in place and
functioning well. There were eighteen excellent and seven good results. The
mean Knee Society functional score was 89 points, and the mean Knee Society
objective score was 91 points. No patient had required additional surgery or
had component loosening.
Conclusions: On the basis of our relatively short-term follow-up
study, custom patellofemoral arthroplasty appears to be a safe and effective
treatment for isolated patellofemoral arthritis of the knee. We believe that
the results presented in this paper justify the additional cost associated
with the custom device.
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.