[When nothing else works: patellofemoral joint arthroplasty]

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Isolated patellofemoral arthritis requires effective treatment, particularly for young patients who may need future revisions.
• Bone-sparing and soft-tissue-preserving techniques are essential for patellofemoral joint replacement in younger demographics.

Purpose of the Study:

• To highlight patellofemoral joint replacement as the optimal treatment for isolated patellofemoral arthritis.
• To emphasize the importance of meticulous patient selection, including clinical examination and imaging, for surgical success.
• To discuss treatment options for the trochlea and the necessity of replacing the retropatellar surface.

Main Methods:

• Review of current treatment strategies for patellofemoral arthritis.
• Analysis of surgical techniques, including inlay and onlay systems for the trochlea.
• Consideration of patient selection criteria and management of additional pathologies.

Main Results:

• Patellofemoral joint replacement is the best option for isolated patellofemoral arthritis.
• Specialized centers report promising results, contrasting with higher revision rates in national joint registries.
• Bone-sparing and soft-tissue-preserving approaches are recommended for young patients.

Conclusions:

• Patellofemoral joint replacement requires careful patient selection and specialized surgical expertise.
• Treatment in specialized centers is recommended due to the rarity of the procedure and potential for high revision rates.
• Bone-sparing techniques are vital for young patients undergoing patellofemoral joint replacement to facilitate future revisions.