Return to Activities After Patellofemoral Arthroplasty
Patellofemoral arthroplasty (PFA) is used to treat isolated patellofemoral arthritis, but little is known about post-PFA activity levels and functional outcome scores.
We reviewed 48 consecutive cases (39 patients) of PFAs performed between 2009 and 2014. Three validated patient-reported outcome measures (Kujala score, Lysholm score, International Knee Documentation Committee score) were used to evaluate knee function before and after surgery.
Patient-reported outcome measures were significantly improved after surgery. Return to previous preferred activity was reported by 72.2% of patients, and 52.8% of patients reported returning to the same activity level or to a higher level.
Historically, the literature evaluating knee arthroplasty outcomes has focused on implant survivorship, pain relief, and patient satisfaction. Our findings show that patients who undergo PFA have a high rate of return to their preferred activities. These findings can be used to inform patients who want to remain active after PFA.
Study Strengths and Limitations
Our study focused on the PFA patient population of a surgical team of 2 fellowship-trained orthopedic surgeons (specialists in treating patellofemoral pathology). Although generalization of our findings to other surgeons and different implants may be limited, the study design standardized treatment in a way that makes these findings more reliable. The 100% follow-up strengthens these findings as well. Last, though the patient population was relatively small, it was consistent with or larger than the PFA patient groups studied previously.
Conclusion
In this study, PROM and pain scores were significantly improved after PFA. That almost 75% of patients returned to their preferred activities and >50% of patients returned at the same or a higher activity level provides useful information for preoperative discussions with patients who want to remain active after PFA. Prospective studies are needed to evaluate the longevity and durability of PFA, particularly in active patients.
