Patellofemoral Joint (PFJ) Arthroplasty in Young Patients: Mid-term Results and Functional Outcomes

Purpose Isolated patellofemoral arthritis is a well-recognized variant of knee osteoarthritis. The cause of isolated patellofemoral arthritis can be traumatic, secondary to malalignment, degenerative, or idiopathic. This study aims to evaluate whether the results of our third-generation patellofemoral arthroplasty (PFA) support its continued use as a viable treatment option for isolated patellofemoral arthritis. Methods A retrospective cohort study was conducted using the electronic NHS trust database to identify all patients who underwent PFA between September 2008 and April 2014. Each patient was subsequently reviewed at our outpatient clinic, where they completed a series of standardized questionnaires to assess treatment outcomes. These included the Short Form 12v2, the Forgotten Joint Score (FJS), the Kujala Score, and the Knee Injury and Osteoarthritis Outcome Score (KOOS). A total of 44 patellofemoral joints (PFJs) were included in the study. Results Four patients required revision surgery to convert their PFJ replacement to a total knee replacement. Additionally, three patients underwent arthroscopy for the management of patella maltracking. When asked about their satisfaction and whether they would choose to undergo the same surgery again, only seven patients indicated that they would opt for the procedure again. The FJS revealed that the majority of patients (85%) reported being rarely or never aware of their artificial joint in daily activities. The average Kujala score was found to be 4, reflecting moderate discomfort or dysfunction levels. The KOOS indicated that most patients experienced mild to moderate symptoms, with occasional bouts of pain and moderate stiffness. Importantly, the KOOS findings also suggested that the patients' daily activities were not severely impacted. Conclusion PFJ arthroplasty can yield positive outcomes for younger patients who suffer from isolated patellofemoral arthritis. However, achieving successful results is heavily influenced by the careful and appropriate selection of patients rather than the choice of the implant itself.