Patellofemoral arthroplasty: the third compartment.

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Rheumatology

Background:

• Isolated patellofemoral arthritis, previously overlooked, is now recognized as a prevalent condition, particularly among women.
• Existing treatments like patellectomy, osteotomies, debridement, and cartilage transplantation have demonstrated limited long-term efficacy.
• This highlights a significant clinical need for effective patellofemoral arthroplasty solutions.

Purpose of the Study:

• To review the current status and future directions of patellofemoral arthroplasty for isolated patellofemoral arthritis.
• To identify optimal surgical indications and assess the outcomes of existing and emerging treatment modalities.

Main Methods:

• Review of current literature and clinical reports on patellofemoral arthroplasty.
• Analysis of surgical indications, including patient demographics and specific arthritic presentations.
• Evaluation of reported short-term and midterm outcomes, focusing on efficacy and complications.

Main Results:

• Short-term to midterm outcomes for patellofemoral arthroplasty range from 60% to 80% good-to-excellent results.
• Primary complications include patellar instability and patellar edge loading on condylar cartilage during flexion.
• Recent advancements in implant design are actively addressing these challenges.

Conclusions:

• Patellofemoral arthroplasty is a viable option for select middle-aged patients with isolated patellofemoral arthritis.
• Ongoing innovations in implant design are crucial for mitigating instability and edge loading issues.
• Further research and development are expected to enhance the long-term success of patellofemoral joint replacement.