The Journal of Bone and Joint Surgery (American). 2006;88:1475-1480.
doi:10.2106/JBJS.E.00382
© 2006 The Journal of Bone and Joint Surgery, Inc.
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Custom Patellofemoral Arthroplasty of the Knee

Domenick J. Sisto, MD1 and Vineet K. Sarin, PhD1

1 Los Angeles Orthopaedic Institute, 4955 Van Nuys Boulevard, Suite 615, Sherman Oaks, CA 91403. E-mail address for D.J. Sisto: laortho1{at}yahoo.com

Investigation performed at Los Angeles Orthopaedic Institute, Sherman Oaks, California

A video supplement to this article will be available from the Video Journal of Orthopaedics. A video clip will be available at the JBJS web site, www.jbjs.org. The Video Journal of Orthopaedics can be contacted at (805) 962-3410, web site: www.vjortho.com.

The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. One or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (V.K. Sarin is an employee of [receives salary from] Kinamed, Inc.). 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: The treatment of isolated patellofemoral arthritis is controversial. Several surgical procedures have been used to treat the severely degenerated patellofemoral joint, with varying degrees of success. The purpose of this study was to determine the clinical results of a custom patellofemoral arthroplasty for the treatment of isolated patellofemoral degenerative arthritis of the knee.

Methods: From 1995 through 2002, twenty-five patellofemoral replacements, three of which were bilateral, were performed in twenty-two patients for the treatment of isolated patellofemoral arthritis of the knee. According to the Ahlback radiographic evaluation scale, the mean preoperative score for the severity of the arthritis was 4.65 points in the patellofemoral compartment and 0.5 point in both the medial and the lateral compartment. The patients included sixteen women (two of whom had a bilateral replacement) and six men (one of whom had a bilateral replacement) with a mean age of forty-five years at the time of the index arthroplasty. Seventeen patients (nineteen knees) had had a prior procedure on the knee. The mean preoperative Knee Society functional score was 49 points, and the mean preoperative Knee Society objective score was 52 points.

Results: At a mean of seventy-three months (range, thirty-two to 119 months) postoperatively, all twenty-five implants were in place and functioning well. There were eighteen excellent and seven good results. The mean Knee Society functional score was 89 points, and the mean Knee Society objective score was 91 points. No patient had required additional surgery or had component loosening.

Conclusions: On the basis of our relatively short-term follow-up study, custom patellofemoral arthroplasty appears to be a safe and effective treatment for isolated patellofemoral arthritis of the knee. We believe that the results presented in this paper justify the additional cost associated with the custom device.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


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Related articles in JBJS:

Custom Patellofemoral Arthroplasty of the Knee. Surgical Technique
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Letters to the Editor:

Read all Letters to the Editor

Custom Patellofemoral Replacement in thePresence Of Trochlear Dysplasia
Ronald P. Grelsamer
JBJS Online, 9 Aug 2006 [Full text]
Drs. Sisto and Sarin respond to Dr. Grelsamer
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