Abstract
Background and purpose — Patellofemoral arthroplasty (PFA) has been debated since early studies showed poor implant survival. Recent studies show better results. This review reports failure modes for PFA and investigates differences in data reported from registries and clinical studies. Additionally, we report differences in failure modes among implant designs.Methods — A systematic search was performed in September 2018. All studies and registers describing failure modes of PFA were included and implant design was noted for each revision.Results — This review includes 1,299 revisions of a primary PFA reported in 47 clinical studies and 3 registers. The failure modes were: 42% OA progression, 16% pain, 13% aseptic loosening, 12% surgical error, 4% wear, 2% infection, 2% broken patellar component, 1% stiffness, 1% fracture, and 7% other. The data from registries and cohort studies differed statistically significantly in 7 out of 12 failure modes. Significant differences were found in several failure modes among implant designs.Interpretation — OA progression is the most common failure mode of PFA. There are significant differences in data on failure modes between registers and protocolled studies, notably for surgical error. The implant design significantly influences several of the failure modes. In conclusion, indication, surgical technique, and implant design are important for a successful PFA, and register-based failure modes should be interpreted with caution.
Highlights
Patellofemoral arthroplasty (PFA) has been debated since early studies showed poor implant survival
This review reports failure modes for PFA and investigates differences in data reported from registries and clinical studies
Indication, surgical technique, and implant design are important for a successful PFA, and register-based failure modes should be interpreted with caution
Summary
Results — This review includes 1,299 revisions of a primary PFA reported in 47 clinical studies and 3 registers. Register studies show poor survival of PFA compared with TKA where the 2-year survival is 91% and 97% and 10-year survival is 73% and 93%, respectively (Odgaard et al 2017) Because of this controversy, we performed a systemic review with the following purposes: (1) to investigate the reasons for revisions of PFA, (2) to highlight possible differences in data from registries and protocolled studies, and (3) describe differences in failure modes among implant designs. In our review we present newer results, a higher number of revisions (1,299 vs 938), and, as van der List et al suggested, we investigate the impact of implant design on failure modes. We focus on the differences between data from registries and protocolled studies
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
