Reliable improvements in participation in low-impact sports following implantation of a patellofemoral inlay arthroplast
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Reliable improvements in participation in low‑impact sports following implantation of a patellofemoral inlay arthroplasty at mid‑term follow‑up Jonas Pogorzelski1 · Marco‑Christopher Rupp1 · Conrad Ketzer1 · Matthias Cotic1 · Patricia Lutz1 · Saskia Beeck1 · Andreas B. Imhoff1 · Matthias J. Feucht1,2 Received: 26 March 2020 / Accepted: 14 August 2020 © The Author(s) 2020
Abstract Purpose The 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. Methods Sixty-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. Results The 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 5°, femoral anteversion > 20°, tibial torsion > 40° [7, 10]), concomitant procedures such as reconstruction of the medial patellofemoral ligament (MPFL), distal femoral osteotomy (DFO), and tibial tuberosity transfer
Knee Surgery, Sports Traumatology, Arthroscopy Table 1 Overall data and descriptive analysis of the entire patient group
Preoperative and perioperative patient characteristics Sex distribution Male Female Age (years) Body mass index (kg/m2) Follow-up (months) Concomitant procedures Yes Osteotomy of the tibial tubercle (n = 2) Isolated MPFL reconstruction (n = 5) Isolated DFO (n = 5) Combined osteotomy of the tibial tubercle and MPFL reconstruction (n = 4) Combined DFO and MPFL reconstruction (n = 1) Combined DFO, MPFL reconstruction, tibial tubercle (n = 1) No Patellar resurfacing Yes No
N = 62 (100%) 26 (42%) 36 (58%) 46 ± 11 27 ± 5 73 ± 25 18 (29%)
44 (71%) 20 (32%) 42 (68%)
Age, body mass index, and follow-up are given as means ± standard deviation N number of patients
%, percent. kg/m2, kilograms per square meter
were performed. Contraindications for PFIA were symptomatic tibiofemoral OA with pain during activities of daily living, inflammatory arthropathy, chondrocalcinosis, chronic regional pain syndrome, active infection, and fixed loss of knee range of motion.
Implant design and surgical technique In all patients, the H emiCAP® Wave Patellofemoral Resurfacing Prosthesis (Arthrosurface, Franklin, MA, USA) was used. The implant consists of a cobalt chrome trochlear component, with titanium surface coating, linked to a titanium taper post, and an optional all-polyethylene patella component. Different implant sizes with varying offsets were available, allowing for a patient-specific treatment. To protect the medial soft-tis
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