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General Orthopaedics

The Cornwall experience of Avon patellofemoral arthroplasty with 5 five-year survivorship and functional results

British Orthopaedic Association/Irish Orthopaedic Association Annual Congress (BOA/IOA)



Abstract

Aim

We aim to show that our series of Avon Patellofemoral Joint Replacements (APFJR) with over 5 year follow up, have comparable functional, radiological and revision rate results to other published reports.

Methods

Retrospective analysis occurred of all consecutive cases of APFJR from October 1999 and January 2010. All operations were performed by the senior author (AL). Each patient had both clinical and radiological follow up. Patient demographics, pre and post op Oxford Knee scores and complications were all recorded. An independent post operative radiological review took place to check for loosening and progression of disease. Revision to Total Knee Replacement (TKR) was taken as the endpoint.

Results

83 consecutive APFJR's were implanted in 56 patients for established isolated patellofemoral arthritis. The average age was 68.2(34–95) with 18 males and 38 females. The mean follow-up was 5.4 years (1.25 to 11). There were 5 revisions with the five-year survival rate being 95.2% (95% confidence interval 88.12%-99.88%). The median Pre Op Oxford knee score was 17 of 48 points (interquartile range 11 to 21) showed significant improvement when compared to the median Post Op Oxford knee score of 35 (interquartile range 26 to 41))(p=< 0.001). There was no loosening with the main complication being radiological progression of arthritis. There was one superficial infection and no deep infections. There was also one transient sciatic nerve palsy. These results compare very closely to those in the designing surgeon's series (Ackroyd et al JBJS Br 2007).

Conclusions

These results reveal satisfactory survivorship and functional outcome results in the medium term leading to increased confidence in the use of patellofemoral arthroplasty