The Journal of Bone and Joint Surgery (American) 84:1977-1981 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.
Total Knee Arthroplasty for Patellofemoral Arthritis
Michael A. Mont, MD,
Steve Haas, MD,
Tarun Mullick, MD and
David S. Hungerford, MD
Investigation performed at the Department of Orthopaedic Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland
Michael A. Mont, MD
Sinai Hospital of Baltimore, Sinai Medical Office Building, Suite 102, 2411 West Belvedere Avenue, Baltimore, MD 21215. E-mail address: rhondamont{at}aol.com
Steve Haas, MD
Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
Tarun Mullick, MD
David S. Hungerford, MD
Department of Orthopaedic Surgery, The Johns Hopkins Medical Institutions at Good Samaritan Hospital, 5601 Loch Raven Boulevard, Baltimore, MD 21239
In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from Stryker-Howmedica-Osteonics. In addition, one or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (Stryker-Howmedica-Osteonics). No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Background: Multiple treatment methods have been advocated for patellofemoral arthritis. The purpose of the present study was to report on our experience with the use of total joint replacement for the treatment of primarily severe patellofemoral arthritis of the knee in patients more than fifty-five years of age.
Methods: Between January 1980 and December 1994, thirty knee replacements were performed in twenty-seven patients for the treatment of arthritis that primarily involved the patellofemoral joint. The Ahlbäck radiographic evaluation scale was used to grade the severity of arthritis; the mean score was 4.83 points (range, 4 to 5 points) for the patellofemoral compartment and 0.6 point (range, 0 to 1 point) for both the medial and lateral compartments. The patients included eighteen women and nine men who had a mean age of seventy-three years (range, fifty-nine to eighty-eight years). None of the patients had had any prior procedures on the knee, but all had been treated for a minimum of six months with nonoperative measures. The mean preoperative Knee Society score was 50 points (range, 20 to 64 points).
Results: At a mean duration of follow-up of eighty-one months (range, forty-eight to 133 months), there were twenty-eight excellent, one good, and one poor result. The mean Knee Society objective score was 93 points (range, 67 to 100 points). The poor result was in a patient who sustained a rupture of the patellar tendon postoperatively as the result of a fall, which necessitated a tendon reconstruction.
Conclusion: Total knee arthroplasty was found to be a viable treatment option in patients more than fifty-five years of age with primarily severe patellofemoral disease.
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