Outcomes of patellofemoral joint arthroplasty: a systematic review of revision timelines and complication rates.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declarations. Ethics approval and consent to participate: A predefined protocol was registered on Prospero and adhered to using PRISMA guidelines. No ethical approval is required for systematic review. Consent for publication: MV-B drafted the initial manuscript, and all authors (DC, JK, CC, AC, AFF, JR, and AL) were involved in revising the manuscript and gave final approval for the publication of the version. All authors had access to all data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. Competing interests: No, I declare that the authors have no competing interests as defined by BMC or other interests that might be perceived to influence the results and/or discussion reported in this paper. 14. Knee Surg Sports Traumatol Arthrosc. 2019 Apr;27(4):1241-1250. doi: 10.1007/s00167-018-5137-6. Epub 2018 Sep 10. Patellofemoral design enhancements reduce long-term complications of postero-stabilized total knee arthroplasty. Jan N(1)(2), Fontaine C(1)(2), Migaud H(1)(2), Pasquier G(1)(2), Valluy J(3), Saffarini M(4), Putman S(1)(2). Author information: (1)Université de Lille Nord de France, Lille, France. (2)Service d'orthopédie C, Hôpital Roger Salengro, Place de Verdun, Centre Hospitalier Régional Universitaire de Lille (CHRU de Lille), Lille Cedex, France. (3)ReSurg SA, ch. de la Vuarpilliere 35, 1260, Nyon, Switzerland. (4)ReSurg SA, ch. de la Vuarpilliere 35, 1260, Nyon, Switzerland. journals@resurg.eu. PURPOSE: Few studies investigated whether trochlear and patellar design enhancements improve long-term outcomes of total knee arthroplasty (TKA). This study aimed to compare the long-term survival and complication rates of two consecutive generations of the same TKA system with identical tibiofemoral geometry, but different patellofemoral designs. METHODS: The authors retrieved the records of 93 patients (104 knees) operated with the HLS II system and 116 patients (122 knees) operated with HLS Evolution system. Patients were evaluated preoperatively and at a minimum of 10 years noting all complications. Kaplan-Meier (KM) survival was compared for two endpoints: (1) revision of all components and (2) revision of any component. RESULTS: From the HLS II series, the incidence of revision of all components was 6.4%, and of any component was 9.8%. From the HLS Evolution series, the incidence of revision of all components was 4.1%, and of any component was 5.1%. Comparing the survival at equivalent follow-up of 14 years, considering revision of all components, the HLS II had higher survival than the HLS Evolution (98.9% vs 95.9%), while considering revision of any component, the HLS II had lower survival than the HLS Evolution (93.0% vs 94.9%). The differences in survival of the two implants were not significant, neither at equivalent follow-up of 14 years (n.s.), nor at maximum follow-up of each cohort (n.s.). The complication rate was higher for the HLS II series compared to the HLS Evolution (28% vs 12%, p = 0.009), but patellofemoral complications were not more frequent (8% vs 6%, n.s.). CONCLUSIONS: Though the differences in survival of the two implants were not significant, conflicting findings are observed due to partial revisions for patellar fractures (5 in the HLS II series and 1 in the HLS Evolution series) which could be related to patellofemoral design enhancements. This study highlights the importance of patello-femoral geometry, which is often overlooked in TKA. LEVEL OF EVIDENCE: Retrospective comparative study, Level III. DOI: 10.1007/s00167-018-5137-6