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- Title
Complications after patello-femoral versus total knee replacement in the treatment of isolated patello-femoral osteoarthritis. A meta-analysis.
- Authors
Dy, C.; Franco, N.; Ma, Y.; Mazumdar, M.; McCarthy, M.; Gonzalez Della Valle, A.
- Abstract
Purpose: Both patellofemoral arthroplasty (PFA) and total knee arthroplasty (TKA) are successful in treating isolated patellofemoral osteoarthritis, but the complication rates after PFA are concerning. We performed a meta-analysis to compare the incidence of complications, re-operations, and revision following PFA and TKA for patellofemoral osteoarthritis. Methods: We systematically identified publications with patients who underwent PFA or TKA for patellofemoral osteoarthritis with minimum 1.5 year follow-up. Demographics, implant (TKA, first [1G] or second-generation [2G] PFA), complications, and cause of re-operations were extracted. Random-effects meta-analysis was used to pool incidence data, which was compared between groups using logistic regression to adjust for length of follow-up. Results: Twenty-eight observational studies and no randomized trials were included in this meta-analysis, which limits its generalizability. There was a higher likelihood of any re-operation (odds ratio 8.06) and revision (OR 8.11) in PFA compared to TKA. Re-operation (OR 4.33) and revision (OR 4.93) were more likely in 1G-PFA than 2G-PFA. When comparing 2G-PFA to TKA, there was no significant difference in re-operation, revision, pain, or mechanical complications. Conclusions: Patients who undergo PFA rather than TKA are more likely to experience complications and require re-operation or revision, but subgroup analysis suggests a relation to implant design. There is no significant difference in re-operation, revision, pain, or mechanical complications between 2G-PFA and TKA. Level of evidence: Systematic review of Level III therapeutic studies, Level III.
- Subjects
STIFLE joint; ARTICULAR ligaments; OSTEOARTHRITIS; TOTAL knee replacement; SURGICAL complications
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2012, Vol 20, Issue 11, p2174
- ISSN
0942-2056
- Publication type
Article
- DOI
10.1007/s00167-011-1677-8