title: Patellofemoral Joint Arthroplasty: Our Experience in Isolated Patellofemoral and Bicompartmental Arthritic Knees.
abstract: BACKGROUND
  Isolated patellofemoral (PF) arthritis is rare, and there is no complete agreement about the best surgical treatment. The operative treatments are total knee arthroplasty and patellofemoral replacement (PFR). The incidence of many early complications of PF arthroplasty has decreased with the introduction of newer designs. Nowadays, the main cause of revision surgery is the progression of tibiofemoral osteoarthritis. In the past, PF arthroplasty was contraindicated in patients with evidence of osteoarthritis or pain in medial or lateral tibiofemoral compartments. The improvement in implant designs and surgical techniques has allowed the addition of a monocompartmental arthroplasty for the medial or lateral tibiofemoral compartment. In this work, we evaluate our first experience with PF arthroplasty and its combination with unicompartmental knee arthroplasty.
  
  
  METHODS
  From May 2014 to March 2016, we treated 14 patients. An isolated PF arthroplasty was performed in six knees (five patients), and a combined PF and unicompartmental knee arthroplasty was performed in nine cases. We observed a significant improvement in the clinical and functional Knee Society Scores (KSSs) after surgery in our patients.
  
  
  RESULTS
  We obtained good results in our cases both for clinical and functional KSSs. Patellar clunk was recorded in one case.
  
  
  CONCLUSIONS
  We are going toward a new attitude in which partial osteoarthritic changes could be treated with partial resurfacing prosthetic solutions such as unicompartmental, bi-unicompartmental or PFR alone, or unicompartmental combined, which respects the cruciates and achieves maximal bone preservation, which is vital, particularly, for young patients.
authors.affiliation: Department of Orthopaedics and Traumatology, San Luigi Hospital of Orbassano, University of Turin, Torino, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Sabatini
authors.affiliation: University of Study of Turin, Turin, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Schirò
authors.affiliation: Department of Orthopaedics, Cottolengo Hospital, Torino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Atzori
authors.affiliation: Department of Orthopaedics and Traumatology, San Luigi Hospital of Orbassano, University of Turin, Torino, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ferrero
authors.affiliation: Department of Orthopaedics Citta della Salute e della Scienza, PO CTO, University of Study of Turin, Torino, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Massè
keywords: bicompartmental knee arthroplasty; patellofemoral arthritis; patellofemoral joint arthroplasty; total knee arthroplasty