A New Type of Partial Knee Replacement - Patellofemoral Joint Replacement

This type of partial knee replacement has now been shown to be useful for two major problems of the kneecap joint (patellofemoral joint):

1.  The primary and classic use of this implant is for isolated patellofemoral arthritis when the rest of the knee joint is in good shape.  If only isolated patellofemoral arthritis is present, then a total knee joint replacement is not required.  This criterion is determined by weight bearing and sunrise x-rays.  If the weight bearing tibia-femoral joint is normal, this person might be a good candidate for a partial knee replacement of the patellofemoral joint.  The x-rays and case below demonstrate bone on bone arthritis of the kneecap joint, and the remainder of the knee being normal.   Again, the new concept in orthopedics is to replace only the worn out portion of the knee, and save as much of the normal knee joint as possible. 

2. I attended the American Academy of Orthopedics surgeons meeting in March, 2010 and patellofemoral joint replacement is now being advocated for younger persons with certain cases of advanced chondromalacia of the patellofemoral joint, not responsive to other surgical procedures.  This means the person has failed at least one arthroscopic lateral release, and possibly failed a micro-fracture or Oates procedure. In these cases the x-rays are usually normal and there is arthroscopic evidence of loss of joint cartilage in the patellofemoral joint.  The primary reason to do this operation is to alleviate persisting and substantial pain.

The good news is that the newer implants, such as I use, have been shown to have an indefinite life expectancy, making this implant suitable for younger persons thirty and up.
The reason that this implant has a long life span is that it does not bear substantial weight during knee motion and is, therefore, not under a lot of mechanical stress.
 
The typical symptoms of a person in need of patellofemoral replacement are pain going up and down stairs, pain squatting, pain getting up from a chair, pain bending and straightening the knee against resistance, along with pain walking.

A patellofemoral replacement is a much smaller operation than a total knee replacement.  The incision is much smaller and all knee ligaments are preserved.  The recovery from a patellofemoral replacement is the quickest of all partial knee replacements. Please don’t have a total knee replacement if all you have is patellofemoral arthritis. The majority of orthopedic surgeons in the U.S. do not perform this procedure at this point in time.   If you are interested in this procedure, please contact me by email with the buttons on the far right.

 

Case #2

 

 

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