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Preliminary radiological results as well as conversion rate in the analysis of onlay patella-femoral joint replacement
ESSKA Academy. Ateschrang A. Nov 8, 2019; 284400; epEKA-75
Atesch Ateschrang
Atesch Ateschrang
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Preliminary radiological results as well as conversion rate in the analysis of onlay patella-femoral joint replacement

ePoster - epEKA-75

Topic: TKA

Ateschrang A.1, Ahmad S.S.2, Schmidutz F.1, Hirschmann M.T.2, Schreiner A.J.2
1Eberhard Karls Universität, Tübingen, Germany, 2University of Basel, Basel, Switzerland

Introduction: Patello-femoral replacement (PRF) strongly relies on the right indication respectively choice of patients. The inlay design has been well evaluated so far in the literature whereas there is little data regarding onlay models with the role of the right choice of implant still remaining unclear. The purpose of this study is the clinical and radiological outcome analysis of an onlay PFR with special emphasis on the conversion and complication rate as well as influencing factors on the outcome respectively the indication.
Objectives: Onlay PFR is clinically and radiologically evaluated and the role of possible influencing risk factors is presented.
Aims: This study aims to better understand and evaluate the role of onlay PFR in patella-femoral joint arthroplasty.
Methods: 40 patients (m/f 18/22; r/l 22/18; mean age 52±9y) who underwent PFR (Zimmer/Biomet PFJ Gender Solutions; onlay design) due to primary/posttraumatic patella-femoral arthritis (27/13) between 2010-2017 were analysed in a consecutive series. Informed consent was obtained and the study was approved by the local recognized medical ethics committee. Besides the collection of general medical data, a clinical examination as well as the assessment of several scores were performed. As the study is still going on, we present preliminary data (n=13) for the radiological analysis. Statistical analysis was performed with Microsoft Excel.
Results: The mean follow-up (n=13) was 5±2y. The femoral torsion (according to Waidelich) was 21(12-35)°. In total, 4/13 had a pathological torsion finding. The TTTG slightly changed from 11±4mm preoperatively to 9±5mm postoperatively and there occurred no significant changes in patella height according to Caton-Deschamps (pre/post 1.0/0.9). 6/13 patients had no trochlear dysplasia whereas the other 7 showed all a dysplasia type B according to Déjour.
Regarding the whole collective, the conversion rate to TKA was 10% (4/40), re-arthroscopy was performed in 6 cases (15%) and further surgery/other revisions were required in 13% of all cases.
Conclusions: Our findings show that PFR still has got a relatively high revision rate respectively conversion rate to TKA. Precise diagnostics is crucial as the right indication usually leads to good clinical as well as functional results. Our further analyses might help to identify more risk factors for unsatisfying outcome. We assume that the role of femoral torsion and the individual anatomy has been underestimated so far.
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