Research Article
Volume 12 Issue 4 - 2021
Patello-Femoral Joint Endoproshetics
SV Gulnazarova1*, SM Kutepov1, TM Isakova1 and AE Sverdlov2
1Ural State Medical University of the Ministry of Health of the Russian Federation, Yekaterinburg, Russia
2Ural Institute of Traumatology and Orthopedics named after V.D. Chaklin, Yekaterinburg, RussiaS
*Corresponding Author: SV Gulnazarova, Ural State Medical University of the Ministry of Health of the Russian Federation, Yekaterinburg, Russia.
Received: January 17, 2021; Published: March 15, 2021




Abstract

The Patello-Femoral Joint (PFJ) plays an important role in the functioning and stability of the knee joint, which is associated with the anatomical features of its structure. Any deviations in the functioning of the PFJ of dysplastic or traumatic origin leads to the formation of Patello-Femoral osteoarthritis (PFOA) in it. [1-4]. Treatment for PFOA includes both non-operative and surgical methods. Conservative technologies with severe degrees of PFOA provide a short-term effect or are ineffective [5]. A large number of surgical methods for the treatment of PFOA are known, which comprise two large groups: extra-articular and intra-articular interventions. Among the latter, arthroscopic technologies are currently leading [6], which are effective mainly for dysplastic arthrosis and patellar chondromalacia in young people [7]. In case of gross violations of the articulating surfaces of the PFJ due to malunited fractures of the patella or distal epimetaphysis of the femur, arthroplastic interventions are used. The latter are aimed at restoring normal relationships in the joint and improving the conditions of sliding in it [8-10]. However, the effect of classical arthroplasty in severe degrees of PFOA is most often short-lived: pain in the anterior part of the knee joint recurs, and the patient's quality of life still suffers significantly [1,11].

Endoprosthetics is one of the radical ways to restore the Palliative Peformance Scale (PPS) occupational or function disability in severe osteoarthritis. In 1955, MacKeever installed the first Press Fit Condylar (PFC) endoprosthesis, but it had to be removed early due to design imperfections [12]. In subsequent years, new instrument technologies were established: various companies created new designs of endoprostheses, improved the surgical technique of their implantation, worked out the issues of indications and contraindications for PPS arthroplasty, analysed the survival rate of various types of prostheses, complications, and treatment outcomes [13-16]. In Russia, publications on PPS endoprosthetics are rare [17,18].

Despite more than 60 years of experience in clinical observations and studies associated with PPC arthroplasty, various aspects of this problem are currently being actively discussed. For example, the economic advantages and complications of this method, the possibility of combining PFJ arthroplasty with uni-compartmental knee replacement, the frequency of PFJ endoprosthesis conversions to a total prosthesis, and others. The authors pay special attention to long-term treatment outcomes, the effectiveness of PFJ arthroplasty and its prospects [19-23].

Objective: To study the long-term outcomes of Patello-Femoral Joint (PFJ) arthroplasty in osteoarthritis stage 2-4.

Materials and methods: The authors performed surgical treatment of 56 patients with arthrosis of the PFJ(PFOA) stages 2 - 4. The patients were examined by clinical and complex radiation methods using CT and MRI. The age of the patients ranged from 25 to 67 years, the average age was 46, the duration of the disease was 1-4 years. All patients presented with severe pain in the anterior part of the knee joint and dysfunction it. Conservative therapy in all patients was ineffective and short-term, despite the systematic course of treatment. Comprehensive preoperative examination of the knee joint revealed the causes of PFOA: impaired congruence of articulated surfaces, localization and degree of cartilage damage, narrowing of the joint gap, the presence of osteophytes and subchondral sclerosis. Thirty-eight (38) patients with PFOA 2 stage. the ventralization of the tibial tuberosity were performed with the formation of a distractional regenerate by Ilizarov apparatus according to the author's method [24]. The pain relief was achieved with a good pain score and the function of the knee joint was significantly improved. In subsequent years, none of the patients in this group not required surgical treatment.

Keywords: Patello-Femoral; Endoproshetics

References

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Citation: SV Gulnazarova., et al. “Patello-Femoral Joint Endoproshetics”. EC Orthopaedics 12.4 (2021): 01-07.

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