Treatment of isolated patellofemoral osteoarthritis with lateral facetectomy plus Insall's realignment procedure: Long-term follow-up

Ferran Montserrat, Eduard Alentorn-Geli, Vicens León, Alberto Ginés-Cespedosa, Pau Rigol

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7 Citations (Scopus)

Abstract

Purpose: To assess the long-term results of lateral facetectomy plus Insall's realignment procedure to treat isolated patellofemoral osteoarthritis. Methods: All consecutive patients undergoing this procedure with a follow-up between 10 and 14 years were included in this study. Subjects were excluded if they had previous patellar dislocation, patellar fracture, tibiofemoral osteoarthritis (except mild cases) or follow-up <10 or >14 years. Failure cases (need for total knee arthroplasty) of this surgical procedure before 10 years of follow-up were considered in the overall failure rate. Clinical, functional and radiographic outcomes were obtained at baseline and compared to postoperative values. Results: Forty-three patients (mean (SD) age 59.7 (8.1) years) had a follow-up between 10 and 14 years and were finally included in this study. The failure rate in the whole series and included patients was 26.4 and 16.3 %, respectively, for a mean (SD) follow-up of 9.2 (3.2) years and 11.7 (1.4) years, respectively. Patellofemoral pain (p < 0.0001), need for NSAIDs (p < 0.0001), longitudinal (p < 0.0001) and transversal (p < 0.0001) patellar glide tests, Zholen's sign (p = 0.0007) and knee effusion (p = 0.02) significantly improved in the follow-up. Postoperative Knee Society Score (KSS) anatomical (p < 0.0001), functional (p < 0.0001) and total (p < 0.0001) scores and Kujala's score (p = 0.001) were significantly higher compared to preoperative values. The patellar tilt (p = 0.001) and shift (p = 0.04) significantly improved postoperatively, whereas the patellofemoral osteoarthritis was not modified (n.s.) with respect to preoperative assessment. Conclusions: The lateral facetectomy plus Insall's realignment procedure was a successful treatment for isolated patellofemoral osteoarthritis from a clinical, functional and radiographic point of view in the long-term follow-up. Level of evidence: Prospective case series, Level IV. © 2013 Springer-Verlag Berlin Heidelberg.
Original languageEnglish
Pages (from-to)2572-2577
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume21
Issue number11
DOIs
Publication statusPublished - 1 Nov 2013

Keywords

  • Facetectomy
  • Long-term results
  • Patellofemoral osteoarthritis
  • Soft-tissue proximal realignment

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