J Knee Surg 2013; 26(04): 219-224
DOI: 10.1055/s-0032-1329233
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Outcomes of Total Knee Replacement after Patellofemoral Arthroplasty

Jonathan Hutt
1   Department of Trauma and Orthopaedics, Croydon University NHS Trust, Surrey, United Kingdom
Matthew Dodd
1   Department of Trauma and Orthopaedics, Croydon University NHS Trust, Surrey, United Kingdom
Henry Bourke
2   Department of Trauma and Orthopaedics, Frimley Park NHS Trust, Surrey, United Kingdom
Jonathan Bell
3   Department of Orthopaedics, Wimbledon Clinics, London, United Kingdom
› Author Affiliations
Further Information

Publication History

13 July 2012

23 August 2012

Publication Date:
30 November 2012 (online)


There is increasing interest in the use of patellofemoral joint replacements and the cohort receiving them are the youngest of any of the groups of patients undergoing a knee arthroplasty. With more contemporary prostheses, progression of arthritis in other parts of the knee joint is becoming the predominant mechanism of failure. We conducted a multicenter retrospective comparative cohort study to discover whether the outcome of total knee replacement is compromised by prior patellofemoral joint arthroplasty. A total of 21 patients with a mean age of 61 years, who were revised from a patellofemoral joint replacement to a total knee replacement, were compared with a matched cohort of patients who underwent primary total knee replacement. At a mean follow-up of 2.4 years, the primary total knee replacement cohort had significantly better Oxford Knee Scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function scores, pain visual analog scores, and EQ–5D scores. There was no significant difference in patient satisfaction or EQ–5D visual analog scale.

Our results indicate that although the revision of a patellofemoral joint replacement to a total knee replacement is a technically straightforward procedure, the eventual outcome may be less satisfactory when compared with a primary total knee replacement.

  • References

  • 1 Ackroyd CE, Newman JH, Evans R, Eldridge JDJ, Joslin CC. The Avon patellofemoral arthroplasty: five-year survivorship and functional results. J Bone Joint Surg Br 2007; 89 (3) 310-315
  • 2 Odumenya M, Costa ML, Parsons N, Achten J, Dhillon M, Krikler SJ. The Avon patellofemoral joint replacement: Five-year results from an independent centre. J Bone Joint Surg Br 2010; 92 (1) 56-60
  • 3 Parvizi J, Stuart MJ, Pagnano MW, Hanssen AD. Total knee arthroplasty in patients with isolated patellofemoral arthritis. Clin Orthop Relat Res 2001; (392) 147-152
  • 4 Meding JB, Wing JT, Keating EM, Ritter MA. Total knee arthroplasty for isolated patellofemoral arthritis in younger patients. Clin Orthop Relat Res 2007; 464: 78-82
  • 5 Thompson NW, Ruiz AL, Breslin E, Beverland DE. Total knee arthroplasty without patellar resurfacing in isolated patellofemoral osteoarthritis. J Arthroplasty 2001; 16 (5) 607-612
  • 6 Lonner JH. Patellofemoral arthroplasty: the impact of design on outcomes. Orthop Clin North Am 2008; 39 (3) 347-354 , vi vi.
  • 7 Lonner JH. Patellofemoral arthroplasty: pros, cons, and design considerations. Clin Orthop Relat Res 2004; (428) 158-165
  • 8 Pearse AJ, Hooper GJ, Rothwell A, Frampton C. Survival and functional outcome after revision of a unicompartmental to a total knee replacement: the New Zealand National Joint Registry. J Bone Joint Surg Br 2010; 92 (4) 508-512
  • 9 Lonner JH, Jasko JG, Booth Jr RE. Revision of a failed patellofemoral arthroplasty to a total knee arthroplasty. J Bone Joint Surg Am 2006; 88 (11) 2337-2342
  • 10 van Jonbergen H-PW, Werkman DM, van Kampen A. Conversion of patellofemoral arthroplasty to total knee arthroplasty: A matched case-control study of 13 patients. Acta Orthop 2009; 80 (1) 62-66
  • 11 Mulford JS, Eldridge JDJ, Porteous AJ, Ackroyd CE, Newman JH. Revision of isolated patellofemoral arthroplasty to total knee replacement. Curr Orthop Pract 2009; 20 (4) 437
  • 12 Whitehouse SL, Lingard EA, Katz JN, Learmonth ID. Development and testing of a reduced WOMAC function scale. J Bone Joint Surg Br 2003; 85 (5) 706-711
  • 13 National Joint Registry. Available at: http://www.njrcentre.org.uk/njrcentre/default.aspx . Accessed April 14, 2012.
  • 14 Charalambous CP, Abiddin Z, Mills SP, Rogers S, Sutton P, Parkinson R. The low contact stress patellofemoral replacement: high early failure rate. J Bone Joint Surg Br 2011; 93 (4) 484-489
  • 15 Leadbetter WB, Ragland PS, Mont MA. The appropriate use of patellofemoral arthroplasty: an analysis of reported indications, contraindications, and failures. Clin Orthop Relat Res 2005; (436) 91-99
  • 16 Nicol SG, Loveridge JM, Weale AE, Ackroyd CE, Newman JH. Arthritis progression after patellofemoral joint replacement. Knee 2006; 13 (4) 290-295