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Patellofemoral Arthroplasty Versus Total Knee Arthroplasty in Patients With Isolated Patellofemoral Osteoarthritis

The American Journal of Orthopedics. 2010 October;39(10):487-491
October 1, 2010|The American Journal of Orthopedics
Dahm DL;Al-Rayashi W;Dajani K;Shah JP;Levy BA;Stuart MJ
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Diane L. Dahm, MD, Walid Al-Rayashi, MD, Khaled Dajani, MD, Jay P. Shah, MD, Bruce A. Levy, MD, and Michael J. Stuart, MD

Dr. Dahm is Associate Professor of Orthopedics, Department of Orthopedic Surgery, Mayo Clinic, and Mayo Clinic College of Medicine, Rochester, Minnesota.

Dr. Al-Rayashi is Resident Physician, New York University Medical Center, New York, New York.

Dr. Dajani is Resident, Department of Anesthesiology, New York Presbyterian Hospital and Weill Cornell Medical College, New York, New York.

Dr. Shah is Resident Physician, Department of Orthopaedic Surgery, University of Alabama, Birmingham, Alabama.

Dr. Levy is Assistant Professor of Orthopedics, Department of Orthopedic Surgery, Mayo Clinic, and Mayo Clinic College of Medicine, Rochester, Minnesota.

Dr. Stuart is Professor of Orthopedics, Mayo Clinic College of Medicine; Vice Chairman, Department of Orthopedic Surgery, Mayo Clinic; and Co-Director, Sports Medicine Center, Mayo Clinic, Rochester, Minnesota.

We identified all patients at our institution who underwent patellofemoral arthroplasty (PFA) or total knee arthroplasty (TKA) as treatment for isolated patellofemoral arthritis (PA) between January 2003 and December 2005. Twenty-three PFA and 22 TKA patients met inclusion criteria. Mean age was 60 years and 69 years, respectively (P = .01). Mean follow-up was 29 months (range, 24 to 49 months) in the PFA group and 27 months (range, 24 to 33 months) in the
TKA group. Mean postoperative Knee Society Clinical Rating System scores were 89 and 90 in the PFA and TKA cohorts, respectively. Mean UCLA scores were
6.6 and 4.2, respectively (P<.0001). Mean blood loss (P = .03) and hospital stay (P = .001) were significantly lower among PFA patients. Linear regression analysis
showed that blood loss, hospital stay, and functional outcomes were not affected by age as an independent variable. No significant complications occurred in the
PFA group. There was one deep vein thrombosis in the TKA group. We conclude that PFA yields clinical outcomes comparable to that of TKA as treatment for
isolated PA and may be a less invasive option for this select subgroup of patients.

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