Patellofemoral Arthroplasty Surgical Technique: Lateral or Medial Parapatellar Approach
| Autor: | Brandon Schneider, Abigail S. Pyne, Sabrina M. Strickland, Stacy H. Jeong, Jared C. Tishelman |
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| Rok vydání: | 2020 |
| Předmět: |
Joint Instability
medicine.medical_specialty Knee Joint Radiography medicine.medical_treatment Total knee arthroplasty Osteoarthritis Medial parapatellar approach Patellofemoral Joint 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Arthroplasty Replacement Knee Retrospective Studies Arthrotomy 030222 orthopedics Surgical approach business.industry Patella Osteoarthritis Knee Patellofemoral arthroplasty medicine.disease Surgery Treatment Outcome Standard error business |
| Zdroj: | The Journal of Arthroplasty. 35:2429-2434 |
| ISSN: | 0883-5403 |
| DOI: | 10.1016/j.arth.2020.04.026 |
| Popis: | Background Patellofemoral arthroplasty (PFA) is an emerging treatment for patients with isolated patellofemoral compartment osteoarthritis. The medial parapatellar approach is the standard arthrotomy but has been shown in total knee arthroplasty to damage the patellar blood supply and increase postoperative patellar instability. The lateral parapatellar approach is an alternative that may reduce the risk of these outcomes. The purpose of this study is to compare the radiographic measures of patellar tracking and patient-reported outcomes of the medial and lateral parapatellar approaches in PFA. Methods Between 2012 and 2019, a retrospective review was performed of 136 knees undergoing PFA at a single institution. Patients were separated by preoperative congruence angle and then surgical approach into 3 cohorts. Preoperative and postoperative patellar tilt and congruence angle were measured. Preoperative and minimum 6-month postoperative patient-reported outcomes scores were collected. Results There were no significant differences in the mean postoperative congruence angle and postoperative patient-reported outcomes among the 3 cohorts. Mean postoperative patellar tilt was normalized only in the abnormal congruence angle/lateral approach group to 2.80° (standard error, 1.85). Conclusion Congruence angle was improved regardless of surgical approach. Patellar tilt was normalized only for the lateral approach in patients with abnormal preoperative congruence angle. There were no significant differences in preoperative and postoperative scores between groups except for preoperative 12-item Short Form Mental Health Survey scores. This study supports that the lateral approach offers improved postoperative patellar tilt compared to a medial approach for PFA while achieving similar patient-reported outcomes. |
| Databáze: | OpenAIRE |
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