Abstract
The functional outcomes in patients undergoing patellofemoral arthroplasty (PFA) with
high occupational demands have not been fully examined. This study assessed return
to work and conversion to TKA rates following PFA in a young, military cohort. Patient
demographics, pain scores, and surgical information were retrospectively collected
for all active-duty military members who underwent PFA over a 4-year period. The data
were then analyzed to calculate return to work, conversion to TKA, and perioperative
complications rates. A total of 48 servicemembers with 60 total PFAs (36 unilateral,
12 bilateral) were included, with a mean follow up of 2.2 years. At the final follow-up,
83% of servicemembers returned to military service or completed their service obligation
after PFA. Conversion to TKA occurred in three (6.2%) patients at an average of 2.4
years after PFA, resulting in a PFA annual revision rate of 2.3%. The mean numeric
rating scale for pain improved from 4.9 ± 2.6 at baseline to 2.5 ± 2.0 postoperatively
(p < 0.001). Servicemembers with at least one prior ipsilateral knee procedure had a
significantly decreased odds ratio (OR) for both occupational outcome failure (OR,
0.03; 95% confidence interval [CI], 0–0.29) and overall failure (OR, 0.13; 95% CI,
0.02–0.78). At an average of 2 years following PFA, 83% of military members returned
to duty, with a low rate of revision to TKA. Prior ipsilateral knee procedure decreased
the probability of medical separation.
Level of Evidence IV
Keywords
patellofemoral arthroplasty - military - functional outcome - physical activity
