Patel Akash, Haider Zakir, Anand Amarjit, Spicer Dominic
Department of Trauma and Orthopaedic, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
J Orthop Surg (Hong Kong). 2017 Jan;25(1):2309499017692705. doi: 10.1177/2309499017692705.
Common surgical treatment options for isolated patellofemoral osteoarthritis include arthroscopic procedures, total knee replacement and patellofemoral replacement. The HemiCap Wave patellofemoral resurfacing prosthesis is a novel inlay design introduced in 2009 with scarce published data on its functional outcomes. We aim to prospectively evaluate early functional outcomes and complications, for patients undergoing a novel inlay resurfacing arthroplasty for isolated patellofemoral arthrosis in an independent centre.
From 2010 to 2013, 16 consecutive patients underwent patellofemoral resurfacing procedures using HemiCap Wave (Arthrosurface Inc., Franklin, Massachusetts, USA) for anterior knee pain with confirmed radiologically and/or arthroscopically isolated severe patellofemoral arthrosis. Standardized surgical technique, as recommended by the implant manufacturer, was followed. Outcome measures included range of movement, functional knee scores (Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Short Form-36 (SF-36)), radiographic disease progression, revision rates and complications.
Eight men and eight women underwent patellofemoral HemiCap Wave resurfacing, with an average age of 63 years (range: 46-83). Average follow-up was 24.1 months (6-34). Overall, post-operative scores were excellent. There was a statistically significant improvement in the post-operative OKS, KOOS and SF-36 scores ( p < 0.01). One patient had radiological disease progression. One patient underwent revision for deep infection. Two other minor complications were observed and treated conservatively.
The HemiCap Wave patellofemoral resurfacing prosthesis has excellent early results in terms of functional outcomes, radiological outcomes and low complication rates. At the very least, early results show that the HemiCap Wave is comparable to more established onlay prostheses. The HemiCap Wave thus provides a safe and effective surgical option in the treatment of isolated patellofemoral osteoarthritis in selected patients.
孤立性髌股关节炎的常见手术治疗选择包括关节镜手术、全膝关节置换和髌股关节置换。HemiCap Wave髌股表面置换假体是2009年推出的一种新型镶嵌设计，关于其功能结果的已发表数据很少。我们旨在对在一个独立中心接受新型镶嵌表面置换术治疗孤立性髌股关节病的患者的早期功能结果和并发症进行前瞻性评估。
2010年至2013年，16例连续患者因前膝痛接受了使用HemiCap Wave（美国马萨诸塞州富兰克林市Arthrosurface公司）进行的髌股表面置换手术，经放射学和/或关节镜检查确诊为孤立性重度髌股关节炎。遵循植入物制造商推荐的标准化手术技术。结果指标包括活动范围、膝关节功能评分（牛津膝关节评分（OKS）、膝关节损伤和骨关节炎结果评分（KOOS）以及简明健康状况调查量表（SF-36））、放射学疾病进展、翻修率和并发症。
8名男性和8名女性接受了髌股HemiCap Wave表面置换，平均年龄63岁（范围：46 - 83岁）。平均随访时间为24.1个月（6 - 34个月）。总体而言，术后评分优异。术后OKS、KOOS和SF-36评分有统计学显著改善（p < 0.01）。1例患者出现放射学疾病进展。1例患者因深部感染接受翻修。观察到另外2例轻微并发症并进行了保守治疗。
HemiCap Wave髌股表面置换假体在功能结果、放射学结果和低并发症发生率方面具有优异的早期效果。至少，早期结果表明HemiCap Wave与更成熟的覆盖假体相当。因此，HemiCap Wave为选定患者治疗孤立性髌股关节炎提供了一种安全有效的手术选择。
