Voordeckers Alec, Avram George, Mengis Natalie, Toth Laszlo, Koch Matthias, Hirschmann Michael T, Ammann Elias
Department of Orthopedic Surgery and Traumatology, Kantonsspital Baselland, 4101, Bruderholz, Schweiz.
Department of Clinical Research, Research Group Michael T. Hirschmann, Regenerative Medicine & Biomechanics, University of Basel, 4001, Basel, Schweiz.
Orthopadie (Heidelb). 2025 May 2. doi: 10.1007/s00132-025-04654-3.
Isolated patellofemoral osteoarthritis is a degenerative disease of the knee joint that may cause disabling pain and functional limitations. When conservative therapy has failed, arthroplasty can significantly improve the quality of life and mobility of affected patients. In such cases, it is important to select the most suitable implant for the patient on an individual basis. This article discusses the decision-making process between patellofemoral arthroplasty, total knee replacement, and bicondylar replacement without patellar resurfacing.
Patellofemoral arthroplasty is mainly used in younger patients and, if implanted correctly, can lead to good results and a delay in the need for total knee replacement. In older patients with isolated patellofemoral osteoarthritis, total knee replacement is usually the preferred option due to its predictable good outcomes and a lower revision rate. In selected cases, particularly with severely thinned patella, retropatellar resurfacing should not be done.
孤立性髌股关节炎是一种膝关节退行性疾病，可导致致残性疼痛和功能受限。当保守治疗失败时，关节成形术可显著改善受影响患者的生活质量和活动能力。在这种情况下，根据患者个体情况选择最合适的植入物非常重要。本文讨论了髌股关节置换、全膝关节置换和不进行髌骨表面置换的双髁置换之间的决策过程。
髌股关节置换主要用于年轻患者，如果植入正确，可取得良好效果并延迟全膝关节置换的需求。对于患有孤立性髌股关节炎的老年患者，全膝关节置换通常是首选方案，因为其预后可预测且翻修率较低。在某些特定情况下，尤其是髌骨严重变薄时，不应进行髌骨表面置换。
