AAOS2017: Patellofemoral arthroplasty vs TKA for patellofemoral OA

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
CONFERENCE ACE REPORTS
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Synopsis
100 patients with isolated patellofemoral osteoarthritis were randomized to undergo either patellofemoral joint arthroplasty (PFA) or total knee arthroplasty (TKA). Patients were followed for a minimum of 2 years, with results related to clinical and functional outcome reported. Results demonstrated significantly Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
Patellofemoral arthroplasty is available for cases of isolated patellofemoral osteoarthritis, however, the evidence evaluating the efficacy of this treatment is conflicting. Results from registry data have suggested that PFA is inferior to standard total knee arthroplasty (TKA) while large cohort studies have suggested the opposite. Nevertheless, there is a lack of high-quality data from randomized controlled trials comparing the outcomes of PFA and TKA.
What was the principal research question?
In the treatment of isolated patellofemoral osteoarthritis, how do clinical outcomes compare between patellofemoral joint arthroplasty and total knee arthroplasty when assessed after a minimum of 2-year follow-up?
Population: 100 patients with severe isolated patellofemoral osteoarthritis (Mean age: 64.2+/-8.9)
Intervention: PFA group: Patients underwent cemented patellofemoral joint arthroplasty (n=50)
Comparison: TKA group: Patients underwent cemented, fixed-bearing, cruciate-retaining total knee arthroplasty (n=50)
Outcomes: Clinical outcomes included Oxford Knee Score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Short Form 36-Item General Health Survey (SF-36), subjective assessment of improvement, and joint range of motion. The incidence of revision and reoperation was recorded.
Methods: RCT
Time: Follow-up was scheduled for 6 weeks, 3, 4, 6, 9, 12 and 24 months.
What were the important findings?
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What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.
Conjeevaram Maheshwer
April 6, 2017
Orthopaedic Surgeon - United States
At 2 years the results seem to bethe same