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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2010 August;61(4):305-18
Patellofemoral joint replacement
Van Jonbergen H. P. W., Van Lingen C. P.
Department of Orthopedic Surgery, Deventer Hospital, Deventer, The Netherlands
Isolated patellofemoral joint osteoarthritis is a degenerative disorder of the knee associated with pain, stiffness, and functional limitation. Non-operative treatment modalities, such as physical therapy, taping, or injection therapy, may result in short-term relief. Partial lateral facetectomy, distal realignment procedures, lateral retinacular release, and other joint-preserving surgical treatments may lead to insufficient, unpredictable, or only short-term improvement. Though total knee replacement with patellar resurfacing results in good predictable and durable results, it is probably too aggressive of a treatment for what is, in effect, a disease confined to one compartment. In patellofemoral arthroplasty, the femorotibial compartments, with cruciate ligaments and menisci, are spared, which may allow the preservation of the physiological biomechanics of the femorotibial joint. The reported clinical results are related to patient selection, prosthetic design properties, and surgical technique, and show good to excellent medium- and long-term results. This review considers the role of patellofemoral joint replacement and other treatment modalities in isolated patellofemoral osteoarthritis.