Significant Functional Improvement at 2 Years After Isolated Patellofemoral Arthroplasty With an Onlay Trochlear Implant, But Low Mental Health Scores Predispose to Dissatisfaction.
BACKGROUND
We reviewed the clinical and radiographic outcomes of a consecutive series of patients who underwent patellofemoral arthroplasty (PFA) using a modern onlay-style trochlear design and all-polyethylene patellar component. An additional goal of the study was to elucidate, for the first time, the extent to which patients were satisfied with their implant and whether expectations were met after undergoing PFA.


METHODS
We identified a consecutive series of 70 knees (53 patients) treated with primary isolated PFA between October 2007 and May 2012. For our clinical outcomes analysis, we included patients with a minimum follow-up of 2 years and available preoperative original Knee Society scores.


RESULTS
At an average 4.9 years of follow-up, the mean range of motion and Knee Society Knee and Function scores improved significantly, and less than 4% of patients required revision arthroplasty. There was no radiographic evidence of component loosening or wear. Despite these improvements, new Knee Society scores indicated that fewer than two-thirds of patients were satisfied or had their expectations met. Dissatisfied patients and those whose expectations were not met had significantly lower Mental Health scores according to the Short Form-36 following PFA.


CONCLUSIONS
Despite the clinical and radiographic success of this implant, patient satisfaction remained low, which may be partially explained by poor mental health.
Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania.
Gregory S
GS
Kazarian
Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania.
T David
TD
Tarity
University of California, San Francisco, California.
Erik N
EN
Hansen
Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania.
Jenny
J
Cai
Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania. Electronic address: Jess.Lonner@rothmaninstitute.com.
Jess H
JH
Lonner
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D057071:Patellofemoral Joint / Q000601:surgery*; D017060:Patient Satisfaction; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies
Knee Society score; mental health; onlay-style implant; patellofemoral arthroplasty; patient satisfaction