N° 002 - July / August 2019
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Technical Advice for Patellofemoral Arthroplasty
By D. Barrett in category
Honorary Senior Consultant Orthopaedic Surgeon, Southampton University Hospital, Southampton, UK Professor of Bioengineering, School of Engineering Sciences, Southampton University, Southampton, UK
Isolated patellofemoral arthroplasty offers many advantages to patients presenting with appropriate patellofemoral disease. The minimal intervention of the procedure, rapid mobilization and higher function above that of total knee replacement make the procedure very appealing. Revision rates however have been historically high, occasionally six times that of total knee replacement (1). Analysis of problems and complications reveals that patellofemoral design may be sufficiently changed to improve outcome, but importantly has identified many surgical techniques which need to be exercised by the operating surgeon in order to assume a successful result. This article details a number of steps and technical tips which will allow the surgeon to successfully perform a technically demanding but rewarding procedure.
1. Preoperative Planning
Patients should be assessed and selected appropriately with bone on bone isolated patellofemoral arthritis which is commonly secondary to lifelong patellofemoral malalignment and should have no tibiofemoral disease. Patients with nonspecific anterior knee pain or regional pain disorders as well as patients with athletic ambitions, should be excluded. Patients should appreciate the implant is a prosthetic and may not perform as well as...
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