Hariri Mustafa, Schwab Hannah, Koch Kevin-Arno, Mick Paul, Nees Timo, Weishorn Johannes, Walker Tilman, Reiner Tobias
Department of Orthopaedics Heidelberg University Hospital Heidelberg Germany.
J Exp Orthop. 2025 Jun 15;12(2):e70287. doi: 10.1002/jeo2.70287. eCollection 2025 Apr.
This study presents the short- to mid-term implant survival rates, along with the clinical and radiographic outcomes, in a consecutive series of patients who underwent third-generation patellofemoral arthroplasty (PFA) at a non-designer centre. Additionally, it explores the impact of prior surgery on clinical outcomes following PFA.
A retrospective analysis of prospectively collected data was conducted for 27 PFAs performed in 23 patients between 2016 and 2023 using the Gender Solutions® Patello-Femoral Joint System. Patients had a mean follow-up of 4.3 years, with clinical assessments including the Oxford Knee Score (OKS), Visual Analogue Scale (VAS), Forgotten Joint Score (FJS), and activity levels (TAS, UCLA). Implant survivorship was analysed using Kaplan-Meier estimators, with endpoints of revision and reoperation.
The mean age at time of surgery was 51.7 ± 10.5 years, with 92.6% of patients being women. The mean body mass index (BMI) was 28.3 ± 4.5. The 5-year implant survival rate was 100% for revisions and 96.3% for reoperations. Statistically significant improvements were observed in OKS (24.7 ± 8.0 to 39.2 ± 8.3, < 0.001), VAS (7.1 ± 2.3 to 2.3 ± 2.8, < 0.001) and range of motion (ROM) (122.1° ± 17° to 134.7° ± 6.8°, = 0.007). Over 85% of patients achieved good to excellent OKS scores, with 92.3% reporting satisfaction. Patients with prior surgery on the affected knee showed higher satisfaction and greater ROM improvement. Obesity was associated with minor reductions in ROM but did not significantly impact overall outcomes.
The short- to mid-term results following third-generation PFA demonstrated high survivorship and excellent clinical outcomes in an independent series. Prior surgery and obesity were not associated with poorer clinical outcomes, supporting the consideration of PFA for these patients when appropriately indicated.
Level III, retrospective cohort study.
本研究报告了在一家非设计中心接受第三代髌股关节置换术（PFA）的连续系列患者的短期至中期植入物存活率，以及临床和影像学结果。此外，还探讨了既往手术对PFA术后临床结果的影响。
对2016年至2023年间23例患者进行的27次PFA手术的前瞻性收集数据进行回顾性分析，使用Gender Solutions®髌股关节系统。患者的平均随访时间为4.3年，临床评估包括牛津膝关节评分（OKS）、视觉模拟量表（VAS）、遗忘关节评分（FJS）和活动水平（TAS、UCLA）。使用Kaplan-Meier估计器分析植入物存活率，终点为翻修和再次手术。
手术时的平均年龄为51.7±10.5岁，92.6%的患者为女性。平均体重指数（BMI）为28.3±4.5。翻修的5年植入物存活率为100%，再次手术的为96.3%。OKS评分（24.7±8.0至39.2±8.3，<0.001）、VAS评分（7.1±2.3至2.3±2.8，<0.001）和活动范围（ROM）（122.1°±17°至134.7°±6.8°，=0.007）有统计学意义的改善。超过85%的患者获得了良好至优秀的OKS评分，92.3%的患者表示满意。患侧膝关节既往接受过手术的患者满意度更高，ROM改善更大。肥胖与ROM的轻微降低有关，但对总体结果没有显著影响。
在一个独立系列中，第三代PFA的短期至中期结果显示出高存活率和优异的临床结果。既往手术和肥胖与较差的临床结果无关，支持在适当指征时考虑为这些患者进行PFA。
III级，回顾性队列研究。
