Patella-Femoral Arthroplasty

Indications:

  • Isolated PF arthritis.
  • Young patients (<50 years).

Contraindications:

  • PF instability.
  • Medial or lateral compartment arthrosis.
  • High-demand patients with false expectations.
  • Inflammatory arthritis.
  • Malalignment.

Results:

  • In appropriate patients, 90% achieve good outcomes at mid-term follow-up.
  • Conversion to Total Knee Replacement (TKR):
    • Some reports indicate that outcomes are worse than primary TKR.
    • Early reports (AAOS 2012).

Press Fit Condylar (PFC) Sigma Registry Data

British Data:

  • All Brands Cemented Unconstrained Fixed Bearing:
    • Revision rate: 2.62% at 8 years.
  • Total PFC Implants:
    • 158,000 PFCs implanted since the registry began.
    • Highest proportion in the UK.
  • All Fixed Bearing Implants:
    • Revision rate: 2.04% at 8 years.
  • Cemented Posterior Stabilized (PS) PFC:
    • Revision rate: 2.25% at 8 years.
  • Cemented Cruciate Retaining (CR) PFC:
    • Revision rate: 1.84% at 8 years.

Swedish Data:

  • 10-Year Follow-Up for TKR:
    • Results given as revision rate and risk of revision compared to AGC knee.
  • 23,000 PFC Implants over the registry period (most of any TKR).
  • Risk of revision for all cemented PFC fixed bearing types:
    • 0.83 below reference (lowest risk of revision of all implants).
  • PFC with Patella Resurfacing:
    • Risk of revision ratio: 1.2.
    • Statistically equal to AGC.
    • Better than all other brands.
  • Cumulative 10-Year Revision Rate for PFC:
    • 4%, lowest rate (lower than AGC).
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