Halai Mansur, Ker Andrew, Anthony Iain, Holt Graeme, Jones Bryn, Blyth Mark
Mansur Halai, Andrew Ker, Iain Anthony, Bryn Jones, Mark Blyth, Department of Trauma and Orthopaedics, Glasgow Royal Infirmary, Glasgow G4 0SF, United Kingdom.
World J Orthop. 2016 Aug 18;7(8):487-93. doi: 10.5312/wjo.v7.i8.487.
To determine outcomes using the Femoro-Patella Vialla (FPV) arthroplasty and if there is an ideal patient for this implant.
A total of 41 FPV patellofemoral joint replacements were performed in 31 patients (22 females, 9 males, mean age 65 years). Mean follow-up was 3.2 years (minimum 2 years). Radiographs were reviewed preoperatively and postoperatively. We assessed whether gender, age, previous surgery, patella atla or trochlear dysplasia influenced patient satisfaction or patient functional outcome.
The median Oxford Knee Score was 40 and the median Melbourne Patellofemoral Score was 21 postoperatively. Seventy-six percent of patients were satisfied, 10% unsure and 14% dissatisfied postoperatively. There was no radiological progression of tibiofemoral joint arthritis, using the Ahlback grading, in any patient. One patient, who was diagnosed with rheumatoid arthritis postoperatively, underwent revision to total knee replacement. There were no intraoperative lateral releases and no implant failures. Gender, age, the presence of trochlear dysplasia, patella alta or bilateral surgery did not influence patient outcome. Previous surgery did not correlate with outcome.
In contrast to the current literature, the FPV shows promising early results. However, we cannot identify a subgroup of patients with superior outcomes.
确定使用股髌维亚拉(FPV)关节成形术的治疗结果,以及是否存在适合该植入物的理想患者。
对31例患者(22例女性,9例男性,平均年龄65岁)进行了41例FPV髌股关节置换术。平均随访时间为3.2年(最短2年)。对术前和术后的X线片进行了评估。我们评估了性别、年龄、既往手术史、高位髌骨或滑车发育不良是否会影响患者满意度或功能结局。
术后牛津膝关节评分中位数为40分,墨尔本髌股关节评分中位数为21分。术后76%的患者满意,10%不确定,14%不满意。使用阿尔贝克分级法,所有患者的胫股关节关节炎均无影像学进展。1例术后诊断为类风湿关节炎的患者接受了全膝关节置换翻修术。术中无外侧松解,无植入物失败。性别、年龄、滑车发育不良、高位髌骨或双侧手术均不影响患者结局。既往手术与结局无关。
与当前文献相反,FPV显示出有希望的早期结果。然而,我们无法确定结局较好的患者亚组。