Wenn nichts mehr geht: Der patellofemorale Gelenkersatz

 

 Buy Article Permissions and Reprints

Zusammenfassung

Der patellofemorale Gelenkersatz stellt die beste verfügbare Therapieoption bei isolierter patellofemoraler Arthrose dar. Vor allem junge Patienten sollten mit möglichst knochensparender Technik unter Erhalt der Weichteile operiert werden, da sie mit hoher Wahrscheinlichkeit im Verlauf des Lebens revidiert werden. Die korrekte Patientenselektion ist wichtig für den Operationserfolg und sollte sowohl eine gründliche klinische Untersuchung als auch Bildgebung beinhalten. Hier ist vor allem auf zusätzliche Pathologien zu achten, die eventuell ebenfalls adressiert werden müssen. Für die Trochlea gibt es mit dem Inlay- und Onlay-System 2 verschiedene moderne Möglichkeiten der Versorgung. Ein Ersatz der retropatellaren Fläche sollte regelhaft erfolgen. Der patellofemorale Gelenkersatz wird immer noch selten durchgeführt, sodass eine Behandlung in spezialisierten Zentren empfohlen wird. Daten aus Endoprothesenregistern zeigen hohe Revisionsraten, während Daten aus Zentren vielversprechende Ergebnisse aufweisen.

Abstract

Patellofemoral joint replacement is the best treatment option available for isolated patellofemoral arthritis. Especially young patients should be operated on with bone-sparing techniques that also preserve the soft tissues, since these patients are very likely to be revised at some point in their lifetime. Correct patient selection is important for the success of surgery and should include a meticulous clinical examination and imaging. Special attention should be paid to additional pathologies that may also need to be addressed. For the trochlea, there are two different options for treatment with the inlay and onlay system. The retropatellar surface should be replaced. Patellofemoral joint replacement is still rarely performed, so treatment in specialised centres is recommended. National joint registry data show high revision rates, while data from centres show promising results.

Publication History

Article published online:
09 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

• Literatur

• 1 Lonner JH. Patellofemoral arthroplasty. Orthopedics 2010; 33: 653 DOI: 10.3928/01477447-20100722-39.
  CrossrefPubMedGoogle Scholar
• 2 Davies AP, Vince AS, Shepstone L. et al. The radiologic prevalence of patellofemoral osteoarthritis. Clinical orthopaedics and related research 2002; 206-212 DOI: 10.1097/00003086-200209000-00020.
  CrossrefPubMedGoogle Scholar
• 3 Anon. National Joint Registry 15th Annual Report 2018 Healthcare Quality Improvement Partnership (HQIP).
  Google Scholar
• 4 Endoprothesenregister Deutschland Jahresbericht 2020.
  Google Scholar
• 5 Beckmann J, Merz C, Huth J. et al. Patella alta and patellar subluxation might lead to early failure with inlay patello-femoral joint arthroplasty. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA 2019; 27: 685-691 DOI: 10.1007/s00167-018-4965-8.
  CrossrefPubMedGoogle Scholar
• 6 Imhoff AB, Feucht MJ, Bartsch E. et al. High patient satisfaction with significant improvement in knee function and pain relief after mid-term follow-up in patients with isolated patellofemoral inlay arthroplasty. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA 2019; 27: 2251-2258 DOI: 10.1007/s00167-018-5173-2.
  CrossrefPubMedGoogle Scholar
• 7 Farr J, Covell DJ, Lattermann C. Cartilage lesions in patellofemoral dislocations: incidents/locations/when to treat. Sports medicine and arthroscopy review 2012; 20: 181-186 DOI: 10.1097/JSA.0b013e318259bc40.
  CrossrefPubMedGoogle Scholar
• 8 Dejour H, Walch G, Nove-Josserand L. et al. Factors of patellar instability: an anatomic radiographic study. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA 1994; 2: 19-26 DOI: 10.1007/bf01552649.
  CrossrefPubMedGoogle Scholar
• 9 Dejour D, Allain J. Histoire naturelle de l’arthrose fémoro-patellaire isolée. Revue de Chirurgie Orthopédique et Réparatrice de l'Appareil Moteur 2004; 90: 89-93 DOI: 10.1016/S0035-1040(04)70244-5.
  CrossrefPubMedGoogle Scholar
• 10 McKeever DC. Patellar prosthesis. The Journal of bone and joint surgery American volume 1955; 37-a: 1074-1084
  CrossrefPubMedGoogle Scholar
• 11 Insall J, Tria AJ, Aglietti P. Resurfacing of the patella. The Journal of bone and joint surgery American volume 1980; 62: 933-936
  CrossrefPubMedGoogle Scholar
• 12 Lonner JH. Patellofemoral arthroplasty: the impact of design on outcomes. The Orthopedic clinics of North America 2008; 39: 347-354, vi DOI: 10.1016/j.ocl.2008.02.002.
  CrossrefPubMedGoogle Scholar
• 13 Lustig S, Magnussen RA, Dahm DL. et al. Patellofemoral arthroplasty, where are we today?. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA 2012; 20: 1216-1226 DOI: 10.1007/s00167-012-1948-z.
  CrossrefPubMedGoogle Scholar
• 14 Henderson IJ, Lavigne P. Periosteal autologous chondrocyte implantation for patellar chondral defect in patients with normal and abnormal patellar tracking. The Knee 2006; 13: 274-279 DOI: 10.1016/j.knee.2006.04.006.
  CrossrefPubMedGoogle Scholar
• 15 Buckup J, Heinz SM, Hoffmann R. Klinische Untersuchung des Kniegelenks. Orthopädie und Unfallchirurgie up2date 2018; 13: 503-517 DOI: 10.1055/s-0043-124762.
  Article in Thieme ConnectPubMedGoogle Scholar
• 16 Amis AA, Senavongse W, Bull AM. Patellofemoral kinematics during knee flexion-extension: an in vitro study. Journal of orthopaedic research: official publication of the Orthopaedic Research Society 2006; 24: 2201-2211 DOI: 10.1002/jor.20268.
  CrossrefPubMedGoogle Scholar
• 17 Caton J, Deschamps G, Chambat P. et al. [Patella infera. Apropos of 128 cases]. Rev Chir Orthop Reparatrice Appar Mot 1982; 68: 317-325
  PubMedGoogle Scholar
• 18 Liebensteiner MC, Dirisamer F, Balcarek P. et al. Guidelines for Treatment of Lateral Patella Dislocations in Skeletally Mature Patients. American journal of orthopedics (Belle Mead, NJ) 2017; 46: E86-E96
  PubMedGoogle Scholar
• 19 Migliorini F, Rath B, Tingart M. et al. Distal alignment procedures for patellofemoral instability: comprehensive review of the literature. European journal of orthopaedic surgery & traumatology: orthopedie traumatologie 2019; 29: 1579-1588 DOI: 10.1007/s00590-019-02451-1.
  CrossrefPubMedGoogle Scholar
• 20 Imhoff AB, Feucht MJ, Meidinger G. et al. Prospective evaluation of anatomic patellofemoral inlay resurfacing: clinical, radiographic, and sports-related results after 24 months. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA 2015; 23: 1299-1307 DOI: 10.1007/s00167-013-2786-3.
  CrossrefPubMedGoogle Scholar
• 21 Feucht MJ, Lutz PM, Ketzer C. et al. Preoperative patellofemoral anatomy affects failure rate after isolated patellofemoral inlay arthroplasty. Archives of orthopaedic and trauma surgery 2020; 140: 2029-2039 DOI: 10.1007/s00402-020-03651-9.
  CrossrefPubMedGoogle Scholar
• 22 Zicaro JP, Yacuzzi C, Astoul Bonorino J. et al. Patellofemoral arthritis treated with resurfacing implant: Clinical outcome and complications at a minimum two-year follow-up. The Knee 2017; 24: 1485-1491 DOI: 10.1016/j.knee.2017.09.003.
  CrossrefPubMedGoogle Scholar
• 23 Thienpont E, Lonner JH. Coronal alignment of patellofemoral arthroplasty. The Knee 2014; 21 (Suppl. 01) S51-S57 DOI: 10.1016/s0968-0160(14)50011-7.
  CrossrefPubMedGoogle Scholar
• 24 van Jonbergen HW, Westerbeek RE. Femoral component rotation in patellofemoral joint replacement. The Knee 2018; 25: 485-490 DOI: 10.1016/j.knee.2018.02.007.
  CrossrefPubMedGoogle Scholar
• 25 Westerbeek RE, Derks RP, Zonneveld BJ. et al. Femoral component rotation in patellofemoral joint replacement: a study protocol for a prospective observational study. Open Orthop J 2015; 9: 45-48 DOI: 10.2174/1874325001509010045.
  CrossrefPubMedGoogle Scholar
• 26 Hendrix MR, Ackroyd CE, Lonner JH. Revision patellofemoral arthroplasty: three- to seven-year follow-up. The Journal of arthroplasty 2008; 23: 977-983 DOI: 10.1016/j.arth.2007.10.019.
  CrossrefPubMedGoogle Scholar
• 27 Calliess T, Ettinger M, Schado S. et al. Patella tracking and patella contact pressure in modular patellofemoral arthroplasty: a biomechanical in vitro analysis. Archives of orthopaedic and trauma surgery 2016; 136: 849-855 DOI: 10.1007/s00402-016-2451-7.
  CrossrefPubMedGoogle Scholar
• 28 Vandenneucker H, Labey L, Vander Sloten J. et al. Isolated patellofemoral arthroplasty reproduces natural patellofemoral joint kinematics when the patella is resurfaced. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA 2016; 24: 3668-3677 DOI: 10.1007/s00167-014-3415-5.
  CrossrefPubMedGoogle Scholar
• 29 Beckmann J, Meier M, Halder A. et al. Patellofemoraler Gelenkersatz. Arthroskopie 2020; 33: 275-281 DOI: 10.1007/s00142-020-00375-1.
  CrossrefPubMedGoogle Scholar
• 30 Davidson PA, Rivenburgh D. Focal anatomic patellofemoral inlay resurfacing: theoretic basis, surgical technique, and case reports. The Orthopedic clinics of North America 2008; 39: 337-346, vi DOI: 10.1016/j.ocl.2008.02.003.
  CrossrefPubMedGoogle Scholar
• 31 Matz J, Howard JL, Morden DJ. et al. Do Changes in Patellofemoral Joint Offset Lead to Adverse Outcomes in Total Knee Arthroplasty With Patellar Resurfacing?. A Radiographic Review. The Journal of arthroplasty 2017; 32: 783-787.e781 DOI: 10.1016/j.arth.2016.08.032.
  CrossrefPubMedGoogle Scholar
• 32 Mofidi A, Bajada S, Holt MD. et al. Functional relevance of patellofemoral thickness before and after unicompartmental patellofemoral replacement. The Knee 2012; 19: 180-184 DOI: 10.1016/j.knee.2011.03.002.
  CrossrefPubMedGoogle Scholar
• 33 Anon. National Joint Registry 14th Annual Report 2017 Healthcare Quality Improvement Partnership (HQIP).
  Google Scholar
• 34 Hernigou P, Caton J. Design, operative technique and ten-year results of the Hermes™ patellofemoral arthroplasty. International orthopaedics 2014; 38: 437-442 DOI: 10.1007/s00264-013-2158-0.
  CrossrefPubMedGoogle Scholar
• 35 Hoogervorst P, de Jong RJ, Hannink G. et al. A 21% conversion rate to total knee arthroplasty of a first-generation patellofemoral prosthesis at a mean follow-up of 9.7 years. International orthopaedics 2015; 39: 1857-1864 DOI: 10.1007/s00264-015-2941-1.
  CrossrefPubMedGoogle Scholar
• 36 Baker P, Jameson S, Critchley R. et al. Center and surgeon volume influence the revision rate following unicondylar knee replacement: an analysis of 23,400 medial cemented unicondylar knee replacements. The Journal of bone and joint surgery American volume 2013; 95: 702-709 DOI: 10.2106/jbjs.L.00520.
  CrossrefPubMedGoogle Scholar
• 37 Liddle AD, Judge A, Pandit H. et al. Adverse outcomes after total and unicompartmental knee replacement in 101,330 matched patients: a study of data from the National Joint Registry for England and Wales. Lancet (London, England) 2014; 384: 1437-1445 DOI: 10.1016/s0140-6736(14)60419-0.
  CrossrefPubMedGoogle Scholar
• 38 Liow MH, Goh GS, Tay DK. et al. Obesity and the absence of trochlear dysplasia increase the risk of revision in patellofemoral arthroplasty. The Knee 2016; 23: 331-337 DOI: 10.1016/j.knee.2015.05.009.
  CrossrefPubMedGoogle Scholar
• 39 Ackroyd CE, Newman JH, Evans R. et al. The Avon patellofemoral arthroplasty: five-year survivorship and functional results. The Journal of bone and joint surgery British volume 2007; 89: 310-315 DOI: 10.1302/0301-620x.89b3.18062.
  CrossrefPubMedGoogle Scholar
• 40 Cartier P, Sanouiller JL, Khefacha A. Long-term results with the first patellofemoral prosthesis. Clinical orthopaedics and related research 2005; 47-54 DOI: 10.1097/01.blo.0000171918.24998.d1.
  CrossrefPubMedGoogle Scholar
• 41 Anon. Annual reports – AOANJRR. 2016.
  Google Scholar
• 42 Feucht MJ, Cotic M, Beitzel K. et al. A matched-pair comparison of inlay and onlay trochlear designs for patellofemoral arthroplasty: no differences in clinical outcome but less progression of osteoarthritis with inlay designs. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA 2017; 25: 2784-2791 DOI: 10.1007/s00167-015-3733-2.
  CrossrefPubMedGoogle Scholar
• 43 Pogorzelski J, Rupp MC, Ketzer C. et al. Reliable improvements in participation in low-impact sports following implantation of a patellofemoral inlay arthroplasty at mid-term follow-up. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA 2020; DOI: 10.1007/s00167-020-06245-5.
  CrossrefPubMedGoogle Scholar
• 44 Dahm DL, Al-Rayashi W, Dajani K. et al. Patellofemoral arthroplasty versus total knee arthroplasty in patients with isolated patellofemoral osteoarthritis. American journal of orthopedics (Belle Mead, NJ) 2010; 39: 487-491
  PubMedGoogle Scholar
• 45 Odgaard A, Madsen F, Kristensen PW. et al. The Mark Coventry Award: Patellofemoral Arthroplasty Results in Better Range of Movement and Early Patient-reported Outcomes Than TKA. Clinical orthopaedics and related research 2018; 476: 87-100 DOI: 10.1007/s11999.0000000000000017.
  CrossrefPubMedGoogle Scholar
• 46 Laskin RS, van Steijn M. Total knee replacement for patients with patellofemoral arthritis. Clinical orthopaedics and related research 1999; 367: 89-95
  PubMedGoogle Scholar
• 47 Mont MA, Haas S, Mullick T. et al. Total knee arthroplasty for patellofemoral arthritis. The Journal of bone and joint surgery American volume 2002; 84: 1977-1981 DOI: 10.2106/00004623-200211000-00011.
  CrossrefPubMedGoogle Scholar
• 48 Dalury DF. Total knee replacement for patellofemoral disease. The journal of knee surgery 2005; 18: 274-277 DOI: 10.1055/s-0030-1248191.
  Article in Thieme ConnectPubMedGoogle Scholar
• 49 Christ AB, Baral E, Koch C. et al. Patellofemoral arthroplasty conversion to total knee arthroplasty: Retrieval analysis and clinical correlation. The Knee 2017; 24: 1233-1239 DOI: 10.1016/j.knee.2017.06.015.
  CrossrefPubMedGoogle Scholar
• 50 Hutt J, Dodd M, Bourke H. et al. Outcomes of total knee replacement after patellofemoral arthroplasty. The journal of knee surgery 2013; 26: 219-223 DOI: 10.1055/s-0032-1329233.
  Article in Thieme ConnectPubMedGoogle Scholar
• 51 Lewis PL, Graves SE, Cuthbert A. et al. What Is the Risk of Repeat Revision When Patellofemoral Replacement Is Revised to TKA? An Analysis of 482 Cases From a Large National Arthroplasty Registry. Clinical orthopaedics and related research 2019; 477: 1402-1410 DOI: 10.1097/corr.0000000000000541.
  CrossrefPubMedGoogle Scholar