Patellofemoraler Ersatz – welche Datenlage haben wir?

Zusammenfassung

Hintergrund: Bei fortgeschrittener isolierter Arthrose des Femoropatellargelenks stellt der endoprothetische Femoropatellarersatz eine Therapieoption dar. Um hiermit ein gutes Ergebnis erzielen zu können, bedarf es der korrekten Patientenauswahl mit isolierter Arthrose ohne Fehllauf und Instabilität der Patella, moderner Prothesen mit femoraler Onlay-Komponente und einer korrekten Implantationstechnik mit korrekter Orientierung der Komponenten und Vermeidung eines Overstuffings der Patella. Patienten und Methoden: 53 Vanguard-Prothesen (Biomet GmbH, Warsaw, IL) wurden in einem Nachuntersuchungszeitraum von 3,7 ± 2,8 (1–8) Jahren untersucht. Ergebnisse: Der Knee Society Score stieg von 117,3 präoperativ auf 181,2 zum Nachuntersuchungszeitraum. Eine Revision erfolgte aufgrund neuropathischer Schmerzen, und es traten 2 periprothetische Patellafrakturen nach Sturz auf. Schlussfolgerung: Bei strenger Indikationsstellung einer isolierten Femoropatellararthrose sind gute Ergebnisse mit modernen Femoropatellarprothesen zu erwarten.

Abstract

Background: Osteoarthritis of the knee joints is rarely seen only in the femoropatellar joint. In isolated severe osteoarthritis of the femoropatellar joint an isolated prosthetic joint replacement of this joint is indicated. To achieve good results, correct patient selection with no arthritis in the femorotibial joint and absence of maltracking and instability of the patella are crucial. Modern prostheses with a femoral onlay component and a proper surgical technique with correct alignment of the prosthetic component and prevention of an overstuffing of the patella are essential. Patients and Methods: Fifty-three Vanguard Prostheses (Biomet GmbH, Warsaw, IL) were examined after a follow-up of 3.7 ± 2.8 (1–8) years. Results: The Knee Society score increased from 117.3 points preoperative to 181.2 points at the follow-up. One knee was revised because of neuropathic pain. Two patients suffered from periprosthetic patellar fractures after falling. Conclusion: In well indicated cases with isolated osteoarthritis of the femoropatellar joint, good clinical results with a femoropatellar prosthesis can be expected.

Schlüsselwörter

Femoropatellargelenk - Arthrose - Prothese

Key words

femoropatellar joint - osteoarthritis - arthroplasty

• Literatur

• 1 McAlindon TE, Snow S, Cooper S et al. Radiographic patterns of osteoarthritis of the knee joint in the community: the importance of the patellofemoral joint. Ann Rheum Dis 1992; 51: 844-849
• 2 Davies AP, Vince AS, Shepstone L et al. The radiologic prevalence of patellofemoral osteoarthritis. Clin Orthop Relat Res 2002; 402: 206-212
• 3 Argenson JN, Flecher X, Parratte S et al. Patellofemoral arthroplasty: an update. Clin Orthop Relat Res 2005; 440: 50-53
• 4 Lonner JH. Patellofemoral arthroplasty: pros, cons, and design considerations. Clin Orthop Relat Res 2004; 428: 158-165
• 5 Tauro B, Ackroyd CE, Newman JH et al. The Lubinus patellofemoral arthroplasty. A five- to ten-year prospective study. J Bone Joint Surg Br 2001; 83: 696-701
• 6 Arciero RA, Toomey HE. Patellofemoral arthroplasty. A three- to nine-year follow-up study. Clin Orthop Relat Res 1988; 236: 60-71
• 7 Cartier P, Sanouiller JL, Grelsamer R. Patellofemoral arthroplasty. 2–12-year follow-up study. J Arthroplasty 1990; 5: 49-55
• 8 Harrington KD. Long-term results for the McKeever patellar resurfacing prosthesis used as a salvage procedure for severe chondromalacia patellae. Clin Orthop Relat Res 1992; 279: 201-213
• 9 Rozbruch JD, Campbell RD, Insall J. Tibial tubercle elevation (the Maquet operation): a clinical study of thirty-one cases. Orthop Trans 1979; 3: 291-292
• 10 Ficat RP, Ficat C, Gedeon P et al. Spongialization: a new treatment for diseased patellae. Clin Orthop Relat Res 1979; 144: 74-83
• 11 Argenson JN, Guillaume JM, Aubaniac JM. Is there a place for patellofemoral arthroplasty?. Clin Orthop Relat Res 1995; 321: 162-167
• 12 Insall J, Tria AJ, Aglietti P. Resurfacing of the patella. J Bone Joint Surg Am 1980; 62: 933-936
• 13 Pickett JC, Stoll DA. Patellaplasty or patellectomy?. Clin Orthop Relat Res 1979; 144: 103-106
• 14 Steurer jr. PA, Gradisar jr. IA, Hoyt jr. WA et al. Patellectomy: a clinical study and biomechanical evaluation. Clin Orthop Relat Res 1979; 144: 84-90
• 15 McKeever DC. Patellar prosthesis. J Bone Joint Surg Am 1955; 37: 1074-1084
• 16 DePalma AF, Sawyer D, Hoffmann JD. Reconsideration of lesions affecting the patellofemoral joint. Clin Orthop Relat Res 1960; 18: 63-85
• 17 Worrell RV. Prosthetic resurfacing of the patella. Clin Orthop Relat Res 1979; 144: 91-97
• 18 Levitt RL. A long-term evaluation of patellar prostheses. Clin Orthop Relat Res 1973; 97: 153-157
• 19 Worrell RV. Resurfacing of the patella in young patients. Orthop Clin North Am 1986; 17: 303-309
• 20 Blazina ME, Fox JM, Del Pizzo W et al. Patellofemoral replacement. Clin Orthop Relat Res 1979; 144: 98-102
• 21 Leadbetter WB, Seyler TM, Ragland P et al. Indications, contraindications, and pitfalls of patellofemoral arthroplasty. J Bone Joint Surg Am 2006; 88 (Suppl. 04) S122-S137
• 22 Lonner JH. Patellofemoral arthroplasty. J Am Acad Orthop Surg 2007; 15: 495-506
• 23 Dahm DL, Al-Rayashi W, Dajani K et al. Patellofemoral arthroplasty versus total knee arthroplasty in patients with isolated patellofemoral osteoarthritis. Am J Orthop 2010; 39: 487-491
• 24 Lonner JH. Patellofemoral arthroplasty: the impact of design on outcomes. Orthop Clin North Am 2008; 39: 347-354
• 25 Lustig S, Magnusson RA, Dahm DL et al. Patellofemoral arthroplasty, where are we today?. Knee Surg Sports Traumatol Arthrosc 2012; 20: 1216-1226
• 26 Kooijman HJ, Driessen AP, van Horn JR. Long-term results of patellofemoral arthroplasty: a report of 56 arthroplasties with 17 years of follow-up. J Bone Joint Surg Br 2003; 85: 836-840
• 27 Ackroyd CE, Chir B. Development and early results of a new patellofemoral arthroplasty. Clin Orthop Relat Res 2005; 436: 7-13
• 28 Odumenya M, Costa ML, Parsons N et al. The Avon patellofemoral joint replacement. Five-year results from an independent centre. J Bone Joint Surg Br 2010; 92: 56-60
• 29 Arnbjörnsson AH, Ryd L. The use of isolated patellar prostheses in Sweden 1977–1986. Int Orthop 1998; 22: 141-144
• 30 Merchant AC. Early results with a total patellofemoral joint replacement arthroplasty prosthesis. J Arthroplasty 2004; 19: 829-836
• 31 Gao X, Xu ZJ, He RX et al. A preliminary report of patellofemoral arthroplasty in isolated patellofemoral arthritis. Chin Med J 2010; 123: 3020-3023
• 32 Dy CJ, Franco N, Ma Y et al. Complications after patello-femoral versus total knee replacement in the treatment of isolated patello-femoral osteoarthritis. A meta-analysis. Knee Surg Sports Traumatol Arthrosc 2012; 20: 2174-2190
• 33 de Winter WE, Feith R, van Loon CJ. The Richards type II patellofemoral arthroplasty: 26 cases followed for 1–20 years. Acta Orthop Scand 2001; 72: 487-490
• 34 Krajca-Radcliffe JB, Coker TP. Patellofemoral arthroplasty: A 2- to 18-year followup study. Clin Orthop Relat Res 1996; 330: 143-151
• 35 Cartier P, Sanouiller JL, Khefacha A. Long-term results with the first patellofemoral prosthesis. Clin Orthop Relat Res 2005; 426: 47-54
• 36 van Jonbergen HP, Werkman DM, Barnaart LF et al. Long-term outcomes of patellofemoral arthroplasty. J Arthroplasty 2010; 25: 1066-1071
• 37 Lubinus HH. Patell glide bearing total replacement. Orthopaedics 1979; 2: 119-127
• 38 Fink B, Schneider T, Tillmann K et al. Die Femoropatellarendoprothese – in der heutigen Zeit noch sinnvoll?. Z Orthop 1999; 137: 247-252
• 39 Smith AM, Peckett WR, Butler-Manuel PA et al. Treatment of patello-femoral arthritis using the Lubinus patello-femoral arthroplasty: a retrospective review. Knee 2002; 9: 27-30
• 40 Board TN, Mahmmod A, Ryan WG et al. The Lubinus patellofemoral arthroplasty: a series of 17 cases. Arch Orthop Trauma Surg 2004; 124: 285-287
• 41 Starks J, Roberts S, White SH. The Avon patellofemoral joint replacement. Independent assessment of early functional outcomes. J Bone Joint Surg Br 2009; 91: 1579-1582
• 42 Mont MA, Johnson AJ, Naziri Q et al. Patellofemoral arthroplasty. 7-year mean follow-up. J Arthroplasty 2012; 27: 358-361
• 43 van Wagenberg JM, Speigner B, Gosens T et al. Midterm clinical results of the Autocentric II patellofemoral prosthesis. Int Orthop 2009; 33: 1603-1608
• 44 Charalambous CP, Abiddin Z, Mills SP et al. The low contact stress patellofemoral replacement. High early failure rate. J Bone Joint Surg Br 2011; 93: 484-489
• 45 Sisto DJ, Sarin VK. Custom patellofemoral arthroplasty of the knee. J Bone Joint Surg Am 2006; 88: 1475-1480