Reliable improvements in participation in low-impact sports following implantation of a patellofemoral inlay arthroplasty at mid-term follow-up

Jonas Pogorzelski,Conrad Ketzer,Andreas B Imhoff,Matthias Cotic,Matthias J Feucht,Patricia Lutz,Saskia Beeck,Marco-Christopher Rupp

doi:10.1007/s00167-020-06245-5

Abstract

PurposeThe aim of this study was, to investigate the rate of return to sports (RTS) and physical activity after implantation of PFIA and to identify factors predictive of improved postoperative sporting ability.MethodsSixty-two patients with a mean age of 46 ± 11 years, who underwent implantation of PFIA at the senior authors’ institution, were enrolled. They were prospectively evaluated preoperatively and at a minimum of 2 years postoperatively with a mean follow-up of 60 ± 25 months. Clinical outcomes, return to sports and activity, type of sport or activity, subjective satisfaction, and frequency were evaluated by questionnaire.ResultsThe transformed overall Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score improved from 67 ± 16 to 77 ± 19 (p = 0.003), Tegner activity scale results improved from 3 ± 2 points to 4 ± 1 points (p < 0.001), and scores on the visual analog scale (VAS) pain scale decreased from 6 ± 2 points to 3 ± 2 points (p < 0.001). The sports frequency increased from 1 ± 2 sessions to 2 ± 1 sessions per week (p = 0.001). Ninety-four percent of the patients who did not fail could return to the same or higher level of sports, with 74% of the patients reporting an improved ability to perform sports. No preoperative factors could be detected to significantly influence RTS after surgery.ConclusionsPFIA is a valid treatment option for the active patient with end-stage isolated patellofemoral OA. Reliable improvements in knee function, pain, and participation in low-impact sports were found.Level of evidenceIV.

Highlights

Patellofemoral inlay arthroplasty (PFIA) is considered as a viable treatment option in the case of end-stage isolated patellofemoral osteoarthritis [7, 10, 11, 18]
While multiple authors reported promising results concerning the return to activities following unicompartmental knee arthroplasty (UKA) of the tibiofemoral joint [14, 20, 30], only limited data exist on the return to activity following patellofemoral arthroplasty [24]
Informed consent was obtained by each patient. If they deceased during follow-up, if they had additional knee surgery, unrelated to the patellofemoral joint on the ipsilateral knee, and if they were converted to a total knee arthroplasty, to precisely evaluate return to sports in a successful PFIA treatment

Summary

Introduction

Patellofemoral inlay arthroplasty (PFIA) is considered as a viable treatment option in the case of end-stage isolated patellofemoral osteoarthritis [7, 10, 11, 18]. Alongside innovation and improvement in PFA models, recent advances in surgical technique, technology, and implant design of patellofemoral inlay arthroplasties (PFIA) have improved the clinical outcomes and survival [10, 27]. This particular patient cohort, has high expectations concerning the postoperative level of physical activity and return to sports. A rising number of studies evaluated the postoperative outcome following PFIA, there is still a lack of information about the postoperative return to sport and physical activity [12, 22]. While multiple authors reported promising results concerning the return to activities following unicompartmental knee arthroplasty (UKA) of the tibiofemoral joint [14, 20, 30], only limited data exist on the return to activity following patellofemoral arthroplasty [24]

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