Abstract
We report the early results of a patello-femoral prosthesis with a more anatomical trochlear component than previously reported designs, and with a patella component, geometry and instrumentation that allows optimum tracking and coverage of the patella, prior to final fixation of the patella component.
The first 115 patello-femoral prostheses were implanted between April 2000 and October 2005, and were followed up in a Special Clinic by one observer, who was not the operating surgeon, using the Bristol Knee Score (BKS), and the Oxford Knee Score (OKS). 115 patello-femoral arthroplasties were performed in 86 patients, 28 bilateral procedures (24.3%). 20 (71%) of which were performed as a single procedure. There were 100 females and 15 males, a ratio of 6.6:1, with a mean age of 70.05 years. (range 57 – 79). There were 9 patients lost to follow up, giving a follow up rate of 89%. The mean period follow up was 36 months (range 12 – 78 months). The median OKS (maximum 12/60) was 40/60 pre-operatively (range 22-46) and 22/60 Post-operatively (range 12 – 38), and the BKS was 45 pre-operatively (range 35 – 65) and 85 post-operatively (range 55 – 100). The mean range of movement was 110° pre-operatively (range 90 – 120°), and 125° (range 90 – 130°) post-operatively.
There was 1 superficial wound infection. 2 knees were revised to total knee replacement for progression of arthritis. Four other patients had re-operations, 1 for bilateral subluxing patellae, 2 for soft tissue problems, 1 patient had a locked knee with displacement of the patella prosthesis, which was revised successfully.
Early results of the FPV prosthesis demonstrate, like other more recent designs, that there are fewer problems with mal alignment and mal tracking than with earlier prosthesis, giving 90% good or excellent results.
