title: Treatment of isolated patellofemoral osteoarthritis with lateral facetectomy plus Insall's realignment procedure: long-term follow-up.
abstract: OBJECTIVE
  To assess the long-term results of lateral facetectomy plus Insall's realignment procedure to treat isolated patellofemoral osteoarthritis.
  
  
  METHODS
  All consecutive patients undergoing this procedure with a follow-up between 10 and 14 years were included in this study. Subjects were excluded if they had previous patellar dislocation, patellar fracture, tibiofemoral osteoarthritis (except mild cases) or follow-up <10 or >14 years. Failure cases (need for total knee arthroplasty) of this surgical procedure before 10 years of follow-up were considered in the overall failure rate. Clinical, functional and radiographic outcomes were obtained at baseline and compared to postoperative values.
  
  
  RESULTS
  Forty-three patients (mean (SD) age 59.7 (8.1) years) had a follow-up between 10 and 14 years and were finally included in this study. The failure rate in the whole series and included patients was 26.4 and 16.3 %, respectively, for a mean (SD) follow-up of 9.2 (3.2) years and 11.7 (1.4) years, respectively. Patellofemoral pain (p < 0.0001), need for NSAIDs (p < 0.0001), longitudinal (p < 0.0001) and transversal (p < 0.0001) patellar glide tests, Zholen's sign (p = 0.0007) and knee effusion (p = 0.02) significantly improved in the follow-up. Postoperative Knee Society Score (KSS) anatomical (p < 0.0001), functional (p < 0.0001) and total (p < 0.0001) scores and Kujala's score (p = 0.001) were significantly higher compared to preoperative values. The patellar tilt (p = 0.001) and shift (p = 0.04) significantly improved postoperatively, whereas the patellofemoral osteoarthritis was not modified (n.s.) with respect to preoperative assessment.
  
  
  CONCLUSIONS
  The lateral facetectomy plus Insall's realignment procedure was a successful treatment for isolated patellofemoral osteoarthritis from a clinical, functional and radiographic point of view in the long-term follow-up.
authors: Department of Orthopaedic Surgery, Hospital de l'Esperança, Parc de Salut Mar, Universitat Autonoma de Barcelona, Av. Sant Josep de la Muntanya, 12 6th floor, 08024, Barcelona, Spain, drfmontserrat@pulso.com.
authors: Ferran
authors: F
authors: Montserrat
authors: Eduard
authors: E
authors: Alentorn-Geli
authors: Vicens
authors: V
authors: León
authors: Alberto
authors: A
authors: Ginés-Cespedosa
authors: Pau
authors: P
authors: Rigol
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000601:surgery*; D010329:Patella / Q000601:surgery*; D057071:Patellofemoral Joint
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