髌股关节置换术治疗孤立性髌股骨关节炎的远期生存率和并发症与骨面切除术相比具有更好的临床效果。

IF 2 Q2 ORTHOPEDICS Journal of Experimental Orthopaedics Pub Date : 2025-01-10 DOI:10.1002/jeo2.70136

J. Martinez-Lozano, L. Martorell-de Fortuny, L. A. Martin-Domínguez, R. Torres-Claramunt, J. Sánchez-Soler, S. Perelli, P. Hinarejos, J. C. Monllau

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引用次数: 0

摘要

目的：本研究旨在分析髌股关节置换术（PFA）治疗孤立性髌股骨关节炎（IPFOA）的临床疗效和生存率。次要目的是将这些结果与历史上接受部分侧面切除术加安装复位（PLFIR）治疗的队列进行比较。我们假设PFA的临床结果和生存率优于PLFIR，并且与文献相当。方法：对120例IPFOA患者进行回顾性分析。PFA系列包括33名在2012年至2019年期间接受治疗的患者，至少随访5年（1.2-12.1年）。PLFIR历史队列研究于1995年至2002年（4.1-15.7岁）进行，共87例患者。术前和术后临床结果采用膝关节社会评分（KSS）和Kujala评分进行评估，生存率通过Kaplan-Meier分析进行评估。采用Cox回归分析确定影响手术失败的因素。结果：PFA组10年生存率为75.8%，需转全膝关节置换术（TKA）的失败率为24.2%。在PLFIR组中，10年生存率为79.3%，尽管26.4%需要TKA。两组KSS和Kujala评分均有显著改善，PFA组Kujala评分改善更明显（p = 0.012）。两组10年生存率无统计学差异（p = 0.056），但PFA组表现出更好的长期临床结果。结论：PFA治疗IPFOA的生存率与PLFIR相当。尽管初始失败率较高，但从长期来看，PFA显示出更大的改善潜力，特别是在膝关节前侧疼痛方面。证据等级：四级，回顾性病例系列分析与历史队列比较。

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Patellofemoral arthroplasty provides similar long-term survival rate and complications with better clinical outcomes compared to facetectomy for the treatment of isolated patellofemoral osteoarthritis

Purpose

This study aimed to analyse the clinical outcomes and survival of patellofemoral arthroplasty (PFA) in treating isolated patellofemoral osteoarthritis (IPFOA) at our centre. The secondary objective was to compare these results with a historical cohort treated with partial lateral facetectomy plus Insall realignment (PLFIR). We hypothesised that clinical outcomes and survival with PFA are superior to PLFIR and comparable to the literature.

Methods

A retrospective analysis of 120 patients with IPFOA was conducted. The PFA series included 33 patients treated between 2012 and 2019 with a minimum follow-up of 5 years (range 1.2–12.1 years). The PLFIR historical cohort treated between 1995 and 2002 (range 4.1–15.7 years) consisted of 87 patients. Preoperative and post-operative clinical outcomes were assessed using the Knee Society Score (KSS) and Kujala score, and survivorship was evaluated via Kaplan–Meier analysis. Cox regression analysis was used to identify factors influencing surgical failure.

Results

The PFA group demonstrated a 75.8% survival rate at 10 years, with a 24.2% failure rate requiring conversion to total knee arthroplasty (TKA). In the PLFIR group, the 10-year survival rate was 79.3%, although 26.4% required TKA. Both groups exhibited significant improvements in KSS and Kujala score, with PFA showing superior Kujala score improvement (p = 0.012). No statistically significant difference in survival between the two groups was observed at 10 years (p = 0.056), but PFA showed better long-term clinical outcomes.

Conclusions

PFA demonstrated comparable survival rates to PLFIR in the treatment of IPFOA. Despite a higher initial failure rate, PFA showed a potential for greater improvement in the long term, particularly in terms of anterior knee pain.