Lonner Jess H
Associate Professor of Orthopaedic Surgery, Rothman Institute, Sidney Kimmel School of Medicine at Thomas Jefferson University, Philadelphia, Pennsylvania.
Instr Course Lect. 2017 Feb 15;66:211-221.
Patellofemoral arthroplasty (PFA) has long been a clinical option for patients with isolated patellofemoral arthritis. However, a high rate of failure as a result of patellar instability related to component malposition, soft-tissue imbalance, errant surgical techniques, and poor trochlear implant designs contributed to the underutilization of PFA. The evolution of surgical indications, trochlear implant design, component positioning, and soft-tissue balance has led to improved patellar tracking, fewer failures related to patellar instability, and improved functional outcomes. The development and broad adoption of onlay-style trochlear components, which can be positioned perpendicular to the AP axis of the femur, has substantially improved patellar tracking and, thus, improved the durability of PFA. In addition, favorable data showing success after secondary surgery or revision to total knee arthroplasty after PFA have emerged, which has led to increased use of PFA in appropriately selected patients.
髌股关节置换术（PFA）长期以来一直是孤立性髌股关节炎患者的一种临床选择。然而，由于与假体位置不当、软组织失衡、手术技术错误以及滑车植入物设计不佳相关的髌骨不稳定导致的高失败率，使得PFA的使用率较低。手术适应症、滑车植入物设计、假体定位和软组织平衡的发展，已使髌骨轨迹得到改善，与髌骨不稳定相关的失败情况减少，功能结果得到改善。可以垂直于股骨前后轴定位的覆盖式滑车组件的开发和广泛应用，已显著改善了髌骨轨迹，从而提高了PFA的耐用性。此外，有良好的数据表明，PFA术后二次手术或翻修为全膝关节置换术后取得了成功，这使得在适当选择的患者中PFA的使用增加。
