54 / 242
P. Erasmus, K.J. Cho, J.H. Müller
54
Conclusion
PFR is a more of a less invasive option for
treating isolated patellofemoral osteoarthritis
than TKR [4]. At present, the outcomes of PFR
have been less satisfactory than that of TKR
and UKR. We do however believe that there is
a place for PFR, taking into consideration that
there is a group of patients with severe
patellofemoral degeneration with normal
tibiofemoral joints. We are optimistic that by
incorporating new technologies like 3D
preoperative planning, virtual implantation,
robotics, patient specific instruments and in
some cases patient specific prostheses, we
should be able to improve the results. With
these technologies, it is possible to
preoperatively position and fit off the shelf
prosthesis. Should it not be possible to properly
fit an off the shelf prosthesis, a patient specific
prosthesis can be designed. By doing this, we
can expect to minimize complications and
ensure constitutional or natural tracking of the
patella. We are doing on-going research to
define the parameters within which a patient
specific prosthesis should be designed to fit
into the patient’s existing anatomy without
creating abnormal kinematics or abnormal
strain on the surrounding soft tissue
structures.
Literature
[1] Huri G, AtayOA, Ergen B, Atesok K, Johnson
DL, Doral MN. 2012. Development of femoral trochlear
groove in growing rabbit after patellar instability.
Knee Surg
Sports Traumatol Arthrosc 20(2): 232-8.
[2] Lang JE, Mannava S, FloydAJ, Goddard MS,
Smith BP, Mofidi A, Seyler TM, Jinnah RH. 2011.
Robotic systems in orthopaedic surgery.
J Bone Joint Surg
Br 93(10): 1296-9.
[3] M JH, Erasmus PJ, Scheffer C. 2012.
Comparison of commercial patellofemoral arthroplasty
systems on the basis of patella kinematics, peri-patellar soft
tissue tension and prosthesis design.
J Mech Med Biol
12(05): 1250086.
[4] Lustig S, Magnussen RA, Dahm DL, Parker
D. 2012. Patellofemoral arthroplasty, where are we today?
Knee Surg Sports Traumatol Arthrosc 20(7): 1216-26.