High survivorship and excellent functional outcome in third‐generation patellofemoral arthroplasty

Abstract Purpose This study presents the short‐ to mid‐term implant survival rates, along with the clinical and radiographic outcomes, in a consecutive series of patients who underwent third‐generation patellofemoral arthroplasty (PFA) at a non‐designer centre. Additionally, it explores the impact o...

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Main Authors: Mustafa Hariri, Hannah Schwab, Kevin‐Arno Koch, Paul Mick, Timo Nees, Johannes Weishorn, Tilman Walker, Tobias Reiner
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Journal of Experimental Orthopaedics
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Online Access:https://doi.org/10.1002/jeo2.70287
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author Mustafa Hariri
Hannah Schwab
Kevin‐Arno Koch
Paul Mick
Timo Nees
Johannes Weishorn
Tilman Walker
Tobias Reiner
author_facet Mustafa Hariri
Hannah Schwab
Kevin‐Arno Koch
Paul Mick
Timo Nees
Johannes Weishorn
Tilman Walker
Tobias Reiner
author_sort Mustafa Hariri
collection DOAJ
description Abstract Purpose This study presents the short‐ to mid‐term implant survival rates, along with the clinical and radiographic outcomes, in a consecutive series of patients who underwent third‐generation patellofemoral arthroplasty (PFA) at a non‐designer centre. Additionally, it explores the impact of prior surgery on clinical outcomes following PFA. Methods A retrospective analysis of prospectively collected data was conducted for 27 PFAs performed in 23 patients between 2016 and 2023 using the Gender Solutions® Patello‐Femoral Joint System. Patients had a mean follow‐up of 4.3 years, with clinical assessments including the Oxford Knee Score (OKS), Visual Analogue Scale (VAS), Forgotten Joint Score (FJS), and activity levels (TAS, UCLA). Implant survivorship was analysed using Kaplan‐Meier estimators, with endpoints of revision and reoperation Results The mean age at time of surgery was 51.7 ± 10.5 years, with 92.6% of patients being women. The mean body mass index (BMI) was 28.3 ± 4.5. The 5‐year implant survival rate was 100% for revisions and 96.3% for reoperations. Statistically significant improvements were observed in OKS (24.7 ± 8.0 to 39.2 ± 8.3, p < 0.001), VAS (7.1 ± 2.3 to 2.3 ± 2.8, p < 0.001) and range of motion (ROM) (122.1° ± 17° to 134.7° ± 6.8°, p = 0.007). Over 85% of patients achieved good to excellent OKS scores, with 92.3% reporting satisfaction. Patients with prior surgery on the affected knee showed higher satisfaction and greater ROM improvement. Obesity was associated with minor reductions in ROM but did not significantly impact overall outcomes. Conclusion The short‐ to mid‐term results following third‐generation PFA demonstrated high survivorship and excellent clinical outcomes in an independent series. Prior surgery and obesity were not associated with poorer clinical outcomes, supporting the consideration of PFA for these patients when appropriately indicated. Level of Evidence Level III, retrospective cohort study.
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spelling doaj-art-4e0ede99e2fd4af8996d2ed0da077a772025-08-20T03:44:05ZengWileyJournal of Experimental Orthopaedics2197-11532025-04-01122n/an/a10.1002/jeo2.70287High survivorship and excellent functional outcome in third‐generation patellofemoral arthroplastyMustafa Hariri0Hannah Schwab1Kevin‐Arno Koch2Paul Mick3Timo Nees4Johannes Weishorn5Tilman Walker6Tobias Reiner7Department of Orthopaedics Heidelberg University Hospital Heidelberg GermanyDepartment of Orthopaedics Heidelberg University Hospital Heidelberg GermanyDepartment of Orthopaedics Heidelberg University Hospital Heidelberg GermanyDepartment of Orthopaedics Heidelberg University Hospital Heidelberg GermanyDepartment of Orthopaedics Heidelberg University Hospital Heidelberg GermanyDepartment of Orthopaedics Heidelberg University Hospital Heidelberg GermanyDepartment of Orthopaedics Heidelberg University Hospital Heidelberg GermanyDepartment of Orthopaedics Heidelberg University Hospital Heidelberg GermanyAbstract Purpose This study presents the short‐ to mid‐term implant survival rates, along with the clinical and radiographic outcomes, in a consecutive series of patients who underwent third‐generation patellofemoral arthroplasty (PFA) at a non‐designer centre. Additionally, it explores the impact of prior surgery on clinical outcomes following PFA. Methods A retrospective analysis of prospectively collected data was conducted for 27 PFAs performed in 23 patients between 2016 and 2023 using the Gender Solutions® Patello‐Femoral Joint System. Patients had a mean follow‐up of 4.3 years, with clinical assessments including the Oxford Knee Score (OKS), Visual Analogue Scale (VAS), Forgotten Joint Score (FJS), and activity levels (TAS, UCLA). Implant survivorship was analysed using Kaplan‐Meier estimators, with endpoints of revision and reoperation Results The mean age at time of surgery was 51.7 ± 10.5 years, with 92.6% of patients being women. The mean body mass index (BMI) was 28.3 ± 4.5. The 5‐year implant survival rate was 100% for revisions and 96.3% for reoperations. Statistically significant improvements were observed in OKS (24.7 ± 8.0 to 39.2 ± 8.3, p < 0.001), VAS (7.1 ± 2.3 to 2.3 ± 2.8, p < 0.001) and range of motion (ROM) (122.1° ± 17° to 134.7° ± 6.8°, p = 0.007). Over 85% of patients achieved good to excellent OKS scores, with 92.3% reporting satisfaction. Patients with prior surgery on the affected knee showed higher satisfaction and greater ROM improvement. Obesity was associated with minor reductions in ROM but did not significantly impact overall outcomes. Conclusion The short‐ to mid‐term results following third‐generation PFA demonstrated high survivorship and excellent clinical outcomes in an independent series. Prior surgery and obesity were not associated with poorer clinical outcomes, supporting the consideration of PFA for these patients when appropriately indicated. Level of Evidence Level III, retrospective cohort study.https://doi.org/10.1002/jeo2.70287patellofemoral arthroplasty (PFA)knee arthroplastyknee replacement
spellingShingle Mustafa Hariri
Hannah Schwab
Kevin‐Arno Koch
Paul Mick
Timo Nees
Johannes Weishorn
Tilman Walker
Tobias Reiner
High survivorship and excellent functional outcome in third‐generation patellofemoral arthroplasty
Journal of Experimental Orthopaedics
patellofemoral arthroplasty (PFA)
knee arthroplasty
knee replacement
title High survivorship and excellent functional outcome in third‐generation patellofemoral arthroplasty
title_full High survivorship and excellent functional outcome in third‐generation patellofemoral arthroplasty
title_fullStr High survivorship and excellent functional outcome in third‐generation patellofemoral arthroplasty
title_full_unstemmed High survivorship and excellent functional outcome in third‐generation patellofemoral arthroplasty
title_short High survivorship and excellent functional outcome in third‐generation patellofemoral arthroplasty
title_sort high survivorship and excellent functional outcome in third generation patellofemoral arthroplasty
topic patellofemoral arthroplasty (PFA)
knee arthroplasty
knee replacement
url https://doi.org/10.1002/jeo2.70287
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