Comparison Treatment Effect Of Patellofemoral Arthroplasty And Total Knee Arthroplasty On Isolated Patellofemoral Arthritis

Backgrounds:Isolated Patellofemoral Arthritis is common etiological factor for patients with Knee joint pain.The patients had symptoms and signs of pain specific to the patellofemoral joint, including anterior knee pain, difficulty in negotiating stairs or walking on the fiat ground and the quality of life were serious influenced. Total knee arthroplasty(TKA) is a effective and mature technology for Patellofemoral Arthritis. Because the disease is mainly involved in the patellofemoral joint, have not yet progressed to the tibiofemoral joint, so the patellofemoral joint replacement concepts from the present to clinical application has been more than50years.In the early stage success rate is not high due to the prosthesis design and operation technical,But with the prosthesis design improvement and operation technology improves,patellofemoral arthroplasty has become an effective method of treatment by many experts recognized. The reports of the new prothesis are still less.Objective:To retrospectively comparison the treatment effect of patellofemoral arthroplasty and total knee arthroplasty for patients with isolated patellofemoral osteoarthritis,and to provide the reference for clinical orthopedist.Methods:From January2007to November2011,60knees in58cases of Isolated Patellofemoral Arthritis were treated with patellofemoral arthroplasty (POA) And total knee arthroplasty,in which,30cases with Total Knee Arthroplasty(patellar also replacement with cemented all-polyethylene patellar component),28cases with Patellofemoral Arthroplasty. Preoperative and postoperative knee function was assessed by the American Knee Society (AKS)scores and Feller Score System for patella. Operation time,blood loss and range of motion(ROM)also were pairwise compared. Anteroposterior and lateral views of the knee as well as anxial views of the patella were taken in radiography. Statistical analyses were performed using SPSS13.0software, significant statistical difference used P<0.05. Results:All patients were follow-up ranged from15months to48months (24.6months on average).In TKA group,The AKS scores improved considerably by23.83points with respect to pain and42.16points with respect to function. The Feller scores also improved considerably by8.1points with respect to function.. In POA group,The AKS scores improved considerably by26.61points with respect to pain and40.18points with respect to function. The Feller scores improved considerably by8..5points with respect to function.Two groups showed no significant diference in postoperative AKS Score and Feller Score(P>0.05),but postoperative score showed significant improvement comparision of preoperative score. Although the clinical outcomes after patellofemoral arthroplasty were not better than those after total knee arthroplasty, patellofemoral arthroplasty exhibited advantages in the shorter operation time, lower blood loss and increased postoperative range of motion.Conclusion:Patients who underwent patellofemoral arthroplasty and total knee arthroplasty had a similar clinic effect on isolated patellofemoral osteoarthritis in short-term. Patellofemoral arthroplasty is an effective treatment, Long-term results need further observation.