Pagano Anna, Agostinone Piero, Alesi Domenico, Caputo Dalila, Neri Maria Pia, Grassi Alberto, Zaffagnini Stefano
Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italia.
Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italia.
Knee Surg Sports Traumatol Arthrosc. 2024 Jun;32(6):1525-1530. doi: 10.1002/ksa.12150. Epub 2024 Mar 26.
The aims of the present study were (1) to evaluate the survival of patellofemoral joint (PFJ) arthroplasty in a large cohort of patients using data obtained from an Italian regional arthroplasty registry and (2) to collect clinical outcomes of a subgroup of patients, with a minimum follow-up of 4 years. The hypotheses were that PFJ arthroplasty is a procedure that had good survival and clinical outcomes, not inferior to those reported in the literature for primary total knee arthroplasty (TKA).
The Register of Orthopaedic Prosthetic Implants (RIPO) of Emilia-Romagna (ER) (Italy) database was searched for the inclusion of all PFJ arthroplasties implanted between 2003 and 2019. PFJ arthroplasties were excluded if they were implanted in patients who lived outside of the ER. The survival information was extrapolated from the RIPO considering the partial or total revision of the implant as failure; moreover, a subgroup of patients was contacted and interviewed by telephone to collect clinical outcomes. Descriptive statistics were used to summarise the data. The survival curve was calculated and plotted using the Kaplan-Meier method.
A total of 126 arthroplasties in 114 patients were included in the final analysis (mean age at surgery 60.1 ± 11.5 years old). The main causes of patellofemoral arthroplasty were primary osteoarthritis (88%) and posttraumatic arthritis (7%). The survival was 90.4 ± 30.6 and 78.8 ± 51.5 at 5 and 10 years of follow-up, respectively. At the latest follow-up, 23 implants failed (18.3%). The main cause of revision was osteoarthrosis progression (34.8%). A total of 44 patients were contacted by telephone to collect clinical outcomes: Western Ontario and McMaster Universities Osteoarthritis Index, functional Knee Society Score, Forgotten Joint Score and Oxford Knee Score. These patients reported good to excellent scores at a medium follow-up of 10.3 ± 4.7 years.
The PFJ showed good survival and clinical outcomes and could be considered a valuable option for patients affected by isolated patellofemoral osteoarthritis.
Level IV.
本研究的目的是：（1）利用从意大利地区关节置换登记处获得的数据，评估一大群患者中髌股关节（PFJ）置换术的生存率；（2）收集一组患者的临床结局，最短随访时间为4年。假设是PFJ置换术是一种具有良好生存率和临床结局的手术，不劣于文献中报道的初次全膝关节置换术（TKA）的生存率和临床结局。
检索意大利艾米利亚-罗马涅（ER）地区的骨科假体植入登记处（RIPO）数据库，纳入2003年至2019年间植入的所有PFJ置换术。如果PFJ置换术植入的患者居住在ER地区以外，则将其排除。从RIPO中推断出生存信息，将植入物的部分或全部翻修视为失败；此外，通过电话联系并采访了一组患者以收集临床结局。使用描述性统计来汇总数据。使用Kaplan-Meier方法计算并绘制生存曲线。
最终分析纳入了114例患者的126例置换术（手术时平均年龄60.1±11.5岁）。髌股关节置换术的主要原因是原发性骨关节炎（88%）和创伤后关节炎（7%）。随访5年和10年时的生存率分别为90.4±30.6和78.8±51.5。在最近一次随访时，23个植入物失败（18.3%）。翻修的主要原因是骨关节炎进展（34.8%）。通过电话联系了44例患者以收集临床结局：西安大略和麦克马斯特大学骨关节炎指数、膝关节功能协会评分、遗忘关节评分和牛津膝关节评分。这些患者在平均10.3±4.7年的随访中报告了良好至优秀的评分。
PFJ显示出良好的生存率和临床结局，可被视为孤立性髌股关节骨关节炎患者的一个有价值的选择。
四级。
