Patellofemoral Replacement With Tibial Tubercle Osteotomy.

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Arthroplasty

Background:

• Patellofemoral arthritis secondary to instability or maltracking presents treatment challenges.
• Isolated patellofemoral arthroplasty (PFA) offers bone preservation and improved kinematics over total knee arthroplasty.
• Current PFA survivorship, while improving, has not reached equivalence with total knee replacement.

Purpose of the Study:

• To describe a preferred surgical technique for managing chronic patellofemoral lateral tracking with end-stage arthritis.
• To investigate the potential benefits of optimizing patellar tracking in PFA outcomes.
• To evaluate the addition of tibial tubercle osteotomy to PFA for improved patient results.

Main Methods:

• Technical description of a combined surgical approach.
• Patient selection criteria for chronic patellofemoral lateral tracking and arthritis.
• Surgical technique focusing on PFA and tibial tubercle osteotomy.

Main Results:

• The described technique aims to correct patellofemoral malalignment.
• Potential for improved patellar tracking and joint congruency.
• Anticipated enhancement of PFA functional outcomes and implant longevity.

Conclusions:

• Combining PFA with tibial tubercle osteotomy is a viable strategy for complex patellofemoral issues.
• Optimizing patellar tracking may be key to improving PFA success rates.
• This approach may offer a solution for patients with recalcitrant patellofemoral maltracking and arthritis.