Sydney Orthopaedic Research Institute, Suite 12, Level 1, 445 Victoria Avenue, Chatswood, NSW, 2067, Australia.
Knee Surg Sports Traumatol Arthrosc. 2012 Jul;20(7):1216-26. doi: 10.1007/s00167-012-1948-z. Epub 2012 Mar 10.
Patellofemoral arthroplasty remains controversial, primarily due to the high failure rates reported with early implants. Numerous case series have been published over the years detailing results of various first- and second-generation implants. The purpose of this work is to summarize results published to date and identify common themes regarding implants, surgical techniques, and indications in order to maximize results of future procedures.
A comprehensive review of the MEDLINE database was carried out to identify all clinical studies related to patellofemoral arthroplasty.
First-generation resurfacing implants were associated with relatively high failure rates in the medium term. Second-generation implants, with femoral cuts based on TKA designs have yielded more promising medium-term results. Surgical indications are specific and must be carefully followed to minimize poor results. Short-term complications are generally related to patellar maltracking, while long-term complications are generally related to progression of osteoarthritis in the tibiofemoral joint. Implant loosening and polyethylene wear are rarely reported. Short-term results are favourable for new technology including custom implants and computer navigated surgery.
Overall, recent improvements in implant design and surgical techniques have resulted in improvements in short- and medium-term results. More work is required to assess the long-term outcomes of modern implant designs.
IV.
髌股关节置换术仍然存在争议，主要是因为早期植入物的失败率较高。多年来已经发表了许多病例系列研究，详细介绍了各种第一代和第二代植入物的结果。这项工作的目的是总结迄今为止发表的结果，并确定关于植入物、手术技术和适应证的常见主题，以便最大限度地提高未来手术的效果。
对 MEDLINE 数据库进行了全面的回顾，以确定所有与髌股关节置换术相关的临床研究。
第一代表面置换植入物在中期具有相对较高的失败率。基于 TKA 设计的第二代植入物具有更有前途的中期结果。手术适应证是特定的，必须仔细遵循，以尽量减少不良结果。短期并发症通常与髌骨轨迹不良有关，而长期并发症通常与胫股关节骨关节炎的进展有关。很少报道植入物松动和聚乙烯磨损。新技术，包括定制植入物和计算机导航手术，具有良好的短期效果。
总的来说，植入物设计和手术技术的近期改进导致了短期和中期结果的改善。需要做更多的工作来评估现代植入物设计的长期结果。
IV。
