Advertisement for orthosearch.org.uk
Orthopaedic Proceedings Logo

Receive monthly Table of Contents alerts from Orthopaedic Proceedings

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

Visit Orthopaedic Proceedings at:

Loading...

Loading...

Full Access

PATELLOFEMORAL ARTHROPLASTY. EIGHT YEARS EXPERIENCE WITH THE AVON DESIGN

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Introduction: Isolated patello-femoral arthritis occurs in up to 10% of patients suffering osteoarthritis of the knee. Reports of patello-femoral replacements have given indifferent results. We report our experience of 350 cases of the Avon Arthroplasty.

Method: In 1994 after experience with the Lubinus prosthesis which had a 50% failure rate at eight years, we defined the design criteria for a new prosthesis. Since September 1996, 350 knees have been treated with this design. Prospective review was undertaken and 150 knees have reached 2 years and 80 knees are at five years with 10 knees at eight years. The outcome was assessed using pain scores, Bartlett’s patella score and the Oxford knee score.

Results: The patients recovered function rapidly and 20 cases (6%) suffered early complications which resolved. The median pain score improved from 15/40 points to 38 at five years. The movement increased from 114 to 120 at five years. The Bartlett patella score improved from 11/30 points to 25 at five years. The Oxford knee score improved from 19/48 points to 40 points at five years.

The functional results are similar or better than those of a total knee replacement. Fourteen patients developed mal-alignment (4%) two of which required distal realignment. There have been no cases of deep infection, fracture, wear or loosening. Twenty seven knees (7%) developed evidence of disease progression, twenty two of which (6%) have required revision to a total knee replacement. Nineteen patients (5%) complained of some persistent anterior knee pain of uncertain cause.

Conclusions: Results to date show a large improvement in pain and function and this improved design has reduced the problems of mal-alignment and polythene wear. There is a low complication rate and an excellent range of movement. Disease progression remains a problem which is not predictable. This type of prosthesis offers an alternative to total knee replacement in this small group of patients with isolated patello-femoral disease with a low morbidity.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.