Patellofemoral Arthrosis and Patellofemoral Arthroplasty

Abstract

The patellofemoral joint tends to develop osteoarthritis due to the high rates of anatomical abnormalities and exposure to large weights through relatively small areas. The rate of isolated patellofemoral arthrosis is 11% in men and 24% in women above 55 years of age. This gender difference may be due to the more frequent presence of patellar aligment problems and dysplasia in women. Although, patellofemoral arthrosis, in general, is treated by conservative methods, surgery should be considered for patients who have failed to benefit from weight loss, physical therapy and drug treatment because the disease leads to pain and loss of function. In the surgical treatment of patellofemoral arthrosis, methods such as arthroscopic debridement, management of loads that affect the patella, cartilage grafting, patellar resurfacing, patellafemoral arthroplasty (PFA), total joint replacement and patellectomy can be used. However, PFA has not been widely used. The reasons were problems with the initial design, and mistakes in patient selection, but those were reduced recently and this has led to increasing interest in the PFA. The current indications of PFA comprise of patients with little or no malalignment, and young patients with isolated patellofemoral disease who were planned for patellectomy due to symptom severity. Indeed, the outcomes from patients who were below 55 years of age with a 5-year follow up are promising. (JAREM 2014; 1: 1-3)