Partial lateral patellar facetectomy combined with lateral retinaculum release for treatment of patellofemoral osteoarthritis

Abstract

Objective To evaluate the clinical outcomes of partial lateral patellar facetectomy (PLPF) combined with lateral retinaculum release (LRR) for treatment of patellofemoral osteoarthritis (PFOA). Methods From June 2017 to March 2018, 30 PFOA patients underwent PLPF combined with LRR at Department of Orthopedics and Traumatology, Foshan Hospital of Traditional Chinese Medicine. They were 7 men and 23 women with an average age of 56.4±9.7 years. Their patellar position, patellofemoral joint function, overall knee function, and quality of life were assessed by comparing preoperation and last follow-up in patellofemoral congruence angle (PFCA), lateral patellofemoral angle (LPFA), modified Kujala score, The Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC), and SF-12 quality of life scale. Results All the patients were followed up for an average of 7.6±3.4 months (from 4 to 13 months). The PFCA was improved from preoperative 22.9°±7.6° to 12.4°±4.2° at the last follow-up, the LPFA from preoperative 3.2°±3.7° to 12.9°±6.0° at the last follow-up, the modified Kujala score from preoperative 17.1±9.8 to 34.3±5.7 at the last follow-up, the WOMAC from preoperative 14.1±5.2 to 5.9±1.7 at the last follow-up, the stiffness index from preoperative 5.5±3.2 to 2.7±1.2 at the last follow-up, daily functional index from preoperative 43.9±9.0 to 25.2±5.4 at the last follow-up, and the SF-12 scores from preoperative 31.3±5.2 to 55.7±6.0 at the last follow-up. All the above comparisons showed a significant difference (P<0.05). Conclusion PLPF combined with LRR is a minimally invasive, easy-to-master and effective knee joint preserving procedure for PFOA as it can significantly relieve joint pain and maximally keep patellar functions. Key words: Osteoarthritis, knee; Arthroplasty; Surgical procedures, minimally invasive; Lateral retinaculum release; Knee joint preserving procedure