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Patellofemoral Arthroplasty. Pearls and Pitfalls

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Anterior Knee Pain and Patellar Instability

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Abstract

A possible treatment of patello-femoral osteoarthritis (PF-OA) is the replacement of the anterior compartment of the knee by a patello-femoral arthroplasty (PFA). An adequate patient selection is essential to use PFA with good results. The preoperative study of the patient should confirm that femoro-tibial compartments are undamaged and it should also rule out the presence of severe limb malalignment. A careful surgical technique is also important to obtain satisfactory results: contemporary PFAs have instruments that make the technique reproducible, but attention must be paid to some technical details, such as the correct rotation of the onlay trochlear component, the adequate choice of the size, and the placement of the trochlear component with an adequate degree of flexion. An increase of the anterior space of the knee caused by an insufficient bone resection in the trochlea or the patella should be avoided. The results of contemporary PFAs appear to be clearly superior to those of the models used some decades ago. PFAs have some advantages over total knee arthroplasties (TKA): a faster postoperative recovery, less early complications as bleeding or infection and slightly superior functional results and range of motion. Nevertheless, the revision rate of PFAs (lower than many years ago) is still higher than that of TKAs. The most common cause of PFA failure is the progression of osteoarthritis to the other knee compartments, but revision of the PFA is in most cases a simple surgery with reproducible results. In conclusion, the use of PFA is a useful treatment in isolated PF-OA, especially in relatively young patients. In elderly patients, the use of TKA is recommended because of the more predictable results.

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Authors and Affiliations

  1. Consorci Parc de Salut Mar. Barcelona Universitat Pompeu Fabra, Barcelona, Spain

    Pedro Hinarejos

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  1. Pedro Hinarejos
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Correspondence to Pedro Hinarejos .

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  1. Department of Orthopedic Surgery, Hospital Arnau de Vilanova, Valencia, Spain

    Vicente Sanchis-Alfonso

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Hinarejos, P. (2023). Patellofemoral Arthroplasty. Pearls and Pitfalls. In: Sanchis-Alfonso, V. (eds) Anterior Knee Pain and Patellar Instability. Springer, Cham. https://doi.org/10.1007/978-3-031-09767-6_41

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  • DOI: https://doi.org/10.1007/978-3-031-09767-6_41

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