Clinical outcomes of patellofemoral arthroplasty: robotic assistance produces superior short and mid-term outcomes
Introduction Patellofemoral arthroplasty (PFA) has been shown to provide symptomatic improvement for isolated patellofemoral osteoarthritis (PFOA). The efficacy of robotic-assisted PFA and the most suitable PFA implant design, however, remain ongoing matters of debate. This study sought to compare c...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2024-09, Vol.144 (9), p.4017-4028 |
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| creator | Katzman, Jonathan L. Buehring, Weston Haider, Muhammad A. Connolly, Patrick Schwarzkopf, Ran Fernandez-Madrid, Ivan |
| description | Introduction
Patellofemoral arthroplasty (PFA) has been shown to provide symptomatic improvement for isolated patellofemoral osteoarthritis (PFOA). The efficacy of robotic-assisted PFA and the most suitable PFA implant design, however, remain ongoing matters of debate. This study sought to compare clinical outcomes between patients who underwent robotic-assisted versus conventional PFAs with inlay and onlay prosthetic designs.
Methods
A single-center retrospective review found 237 knees (211 patients) which underwent PFA between 2011 and 2021. One hundred eighty-four knees were included in the final analysis after cases were excluded for having indications other than osteoarthritis or having less than one year of follow-up. There were 90 conventional PFAs and 94 robotic-assisted PFAs performed. Inlay components were implanted in 89 knees and onlay components were implanted in 95 knees. Propensity score matching was utilized to address demographic differences between groups.
Results
Overall, there was a revision-free survivorship rate of 89.7% with an average time to follow-up of 4.6 years (range 1.2 to 11.1). Twenty-nine knees (15.8%) required various non-conversion procedures. The conventional matched cohort exhibited a higher all-cause revision rate, accounting for revision PFAs and conversions to TKA, (18.8 vs. 6.4%, p = 0.014) and a shorter mean time to revision than the robotic-assisted cohort (3.1 vs. 5.8 years, p = 0.026). A Kaplan–Meier survivorship curve showed differences between the conventional and robotics cohorts (p = 0.041). All revisions following robotic-assisted PFA were caused by progression of osteoarthritis, whereas conventional PFAs also required revision due to aseptic loosening and patellar maltracking. The rate of infection resulting in irrigation and debridement was higher for conventional cases (4.3 vs. 0%, p = 0.041). No significant differences in clinical outcomes between the inlay and onlay prosthetic design matched cohorts were identified.
Conclusion
PFA is an effective treatment for addressing advanced patellofemoral arthritis. Robotic-assisted surgery may lead to improved clinical outcomes.
Level of evidence
III. |
| doi_str_mv | 10.1007/s00402-024-05263-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2958292062</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2958292062</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-a191f2fe4256b2b794c36ad2236b99271c85c64064c1d5d51da4d1ce6ec102783</originalsourceid><addsrcrecordid>eNp9kc1O3DAUha2KqtChL8ACWWLDJq197XgSdmgEbSWkbsracmynE5TEwddZzDw9ns50QCy6sqX7nXN_DiEXnH3ljC2_IWOSQcFAFqwEJYrtB3LGpZCFqLk6efM_JZ8RnxjjUNXsEzkVlayBKXlG4qrvxs6anoY52TB4pKGlk0m-70PrhxBzycS0jmHqDabNDY2hCamz1CB2mMxoPZ1icLPNWpwnH7sQKa5DTNSMjg6dK5KPw7HBOfnYmh79l8O7II_3d79XP4qHX99_rm4fCitApcLwmrfQegmlaqBZ1tIKZRyAUE1dw5LbqrRK5i0sd6UruTPSceuVt5zBshILcr33zdM9zx6THjq0eS8z-jCjhrqsYHcGyOjVO_QpzHHM02mRbyYr4KrMFOwpGwNi9K2eYjeYuNGc6V0iep-Izonov4nobRZdHqznZvDuKPkXQQbEHsBcGv_4-Nr7P7YvN_SYpQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3128482165</pqid></control><display><type>article</type><title>Clinical outcomes of patellofemoral arthroplasty: robotic assistance produces superior short and mid-term outcomes</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Katzman, Jonathan L. ; Buehring, Weston ; Haider, Muhammad A. ; Connolly, Patrick ; Schwarzkopf, Ran ; Fernandez-Madrid, Ivan</creator><creatorcontrib>Katzman, Jonathan L. ; Buehring, Weston ; Haider, Muhammad A. ; Connolly, Patrick ; Schwarzkopf, Ran ; Fernandez-Madrid, Ivan</creatorcontrib><description>Introduction
Patellofemoral arthroplasty (PFA) has been shown to provide symptomatic improvement for isolated patellofemoral osteoarthritis (PFOA). The efficacy of robotic-assisted PFA and the most suitable PFA implant design, however, remain ongoing matters of debate. This study sought to compare clinical outcomes between patients who underwent robotic-assisted versus conventional PFAs with inlay and onlay prosthetic designs.
Methods
A single-center retrospective review found 237 knees (211 patients) which underwent PFA between 2011 and 2021. One hundred eighty-four knees were included in the final analysis after cases were excluded for having indications other than osteoarthritis or having less than one year of follow-up. There were 90 conventional PFAs and 94 robotic-assisted PFAs performed. Inlay components were implanted in 89 knees and onlay components were implanted in 95 knees. Propensity score matching was utilized to address demographic differences between groups.
Results
Overall, there was a revision-free survivorship rate of 89.7% with an average time to follow-up of 4.6 years (range 1.2 to 11.1). Twenty-nine knees (15.8%) required various non-conversion procedures. The conventional matched cohort exhibited a higher all-cause revision rate, accounting for revision PFAs and conversions to TKA, (18.8 vs. 6.4%, p = 0.014) and a shorter mean time to revision than the robotic-assisted cohort (3.1 vs. 5.8 years, p = 0.026). A Kaplan–Meier survivorship curve showed differences between the conventional and robotics cohorts (p = 0.041). All revisions following robotic-assisted PFA were caused by progression of osteoarthritis, whereas conventional PFAs also required revision due to aseptic loosening and patellar maltracking. The rate of infection resulting in irrigation and debridement was higher for conventional cases (4.3 vs. 0%, p = 0.041). No significant differences in clinical outcomes between the inlay and onlay prosthetic design matched cohorts were identified.
Conclusion
PFA is an effective treatment for addressing advanced patellofemoral arthritis. Robotic-assisted surgery may lead to improved clinical outcomes.
Level of evidence
III.</description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-024-05263-z</identifier><identifier>PMID: 38492064</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Arthroplasty, Replacement, Knee - methods ; Clinical outcomes ; Female ; Humans ; Joint surgery ; Knee Arthroplasty ; Knee Prosthesis ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Orthopedics ; Osteoarthritis ; Osteoarthritis, Knee - surgery ; Patellofemoral Joint - surgery ; Prostheses ; Prosthesis Design ; Reoperation - statistics & numerical data ; Retrospective Studies ; Robotic Surgical Procedures - methods ; Robotics ; Treatment Outcome</subject><ispartof>Archives of orthopaedic and trauma surgery, 2024-09, Vol.144 (9), p.4017-4028</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-a191f2fe4256b2b794c36ad2236b99271c85c64064c1d5d51da4d1ce6ec102783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-024-05263-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-024-05263-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38492064$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Katzman, Jonathan L.</creatorcontrib><creatorcontrib>Buehring, Weston</creatorcontrib><creatorcontrib>Haider, Muhammad A.</creatorcontrib><creatorcontrib>Connolly, Patrick</creatorcontrib><creatorcontrib>Schwarzkopf, Ran</creatorcontrib><creatorcontrib>Fernandez-Madrid, Ivan</creatorcontrib><title>Clinical outcomes of patellofemoral arthroplasty: robotic assistance produces superior short and mid-term outcomes</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
Patellofemoral arthroplasty (PFA) has been shown to provide symptomatic improvement for isolated patellofemoral osteoarthritis (PFOA). The efficacy of robotic-assisted PFA and the most suitable PFA implant design, however, remain ongoing matters of debate. This study sought to compare clinical outcomes between patients who underwent robotic-assisted versus conventional PFAs with inlay and onlay prosthetic designs.
Methods
A single-center retrospective review found 237 knees (211 patients) which underwent PFA between 2011 and 2021. One hundred eighty-four knees were included in the final analysis after cases were excluded for having indications other than osteoarthritis or having less than one year of follow-up. There were 90 conventional PFAs and 94 robotic-assisted PFAs performed. Inlay components were implanted in 89 knees and onlay components were implanted in 95 knees. Propensity score matching was utilized to address demographic differences between groups.
Results
Overall, there was a revision-free survivorship rate of 89.7% with an average time to follow-up of 4.6 years (range 1.2 to 11.1). Twenty-nine knees (15.8%) required various non-conversion procedures. The conventional matched cohort exhibited a higher all-cause revision rate, accounting for revision PFAs and conversions to TKA, (18.8 vs. 6.4%, p = 0.014) and a shorter mean time to revision than the robotic-assisted cohort (3.1 vs. 5.8 years, p = 0.026). A Kaplan–Meier survivorship curve showed differences between the conventional and robotics cohorts (p = 0.041). All revisions following robotic-assisted PFA were caused by progression of osteoarthritis, whereas conventional PFAs also required revision due to aseptic loosening and patellar maltracking. The rate of infection resulting in irrigation and debridement was higher for conventional cases (4.3 vs. 0%, p = 0.041). No significant differences in clinical outcomes between the inlay and onlay prosthetic design matched cohorts were identified.
Conclusion
PFA is an effective treatment for addressing advanced patellofemoral arthritis. Robotic-assisted surgery may lead to improved clinical outcomes.
Level of evidence
III.</description><subject>Adult</subject><subject>Aged</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Clinical outcomes</subject><subject>Female</subject><subject>Humans</subject><subject>Joint surgery</subject><subject>Knee Arthroplasty</subject><subject>Knee Prosthesis</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Patellofemoral Joint - surgery</subject><subject>Prostheses</subject><subject>Prosthesis Design</subject><subject>Reoperation - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Robotics</subject><subject>Treatment Outcome</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1O3DAUha2KqtChL8ACWWLDJq197XgSdmgEbSWkbsracmynE5TEwddZzDw9ns50QCy6sqX7nXN_DiEXnH3ljC2_IWOSQcFAFqwEJYrtB3LGpZCFqLk6efM_JZ8RnxjjUNXsEzkVlayBKXlG4qrvxs6anoY52TB4pKGlk0m-70PrhxBzycS0jmHqDabNDY2hCamz1CB2mMxoPZ1icLPNWpwnH7sQKa5DTNSMjg6dK5KPw7HBOfnYmh79l8O7II_3d79XP4qHX99_rm4fCitApcLwmrfQegmlaqBZ1tIKZRyAUE1dw5LbqrRK5i0sd6UruTPSceuVt5zBshILcr33zdM9zx6THjq0eS8z-jCjhrqsYHcGyOjVO_QpzHHM02mRbyYr4KrMFOwpGwNi9K2eYjeYuNGc6V0iep-Izonov4nobRZdHqznZvDuKPkXQQbEHsBcGv_4-Nr7P7YvN_SYpQ</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Katzman, Jonathan L.</creator><creator>Buehring, Weston</creator><creator>Haider, Muhammad A.</creator><creator>Connolly, Patrick</creator><creator>Schwarzkopf, Ran</creator><creator>Fernandez-Madrid, Ivan</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20240901</creationdate><title>Clinical outcomes of patellofemoral arthroplasty: robotic assistance produces superior short and mid-term outcomes</title><author>Katzman, Jonathan L. ; Buehring, Weston ; Haider, Muhammad A. ; Connolly, Patrick ; Schwarzkopf, Ran ; Fernandez-Madrid, Ivan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-a191f2fe4256b2b794c36ad2236b99271c85c64064c1d5d51da4d1ce6ec102783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Arthroplasty, Replacement, Knee - methods</topic><topic>Clinical outcomes</topic><topic>Female</topic><topic>Humans</topic><topic>Joint surgery</topic><topic>Knee Arthroplasty</topic><topic>Knee Prosthesis</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>Patellofemoral Joint - surgery</topic><topic>Prostheses</topic><topic>Prosthesis Design</topic><topic>Reoperation - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Robotics</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Katzman, Jonathan L.</creatorcontrib><creatorcontrib>Buehring, Weston</creatorcontrib><creatorcontrib>Haider, Muhammad A.</creatorcontrib><creatorcontrib>Connolly, Patrick</creatorcontrib><creatorcontrib>Schwarzkopf, Ran</creatorcontrib><creatorcontrib>Fernandez-Madrid, Ivan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Katzman, Jonathan L.</au><au>Buehring, Weston</au><au>Haider, Muhammad A.</au><au>Connolly, Patrick</au><au>Schwarzkopf, Ran</au><au>Fernandez-Madrid, Ivan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical outcomes of patellofemoral arthroplasty: robotic assistance produces superior short and mid-term outcomes</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>144</volume><issue>9</issue><spage>4017</spage><epage>4028</epage><pages>4017-4028</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
Patellofemoral arthroplasty (PFA) has been shown to provide symptomatic improvement for isolated patellofemoral osteoarthritis (PFOA). The efficacy of robotic-assisted PFA and the most suitable PFA implant design, however, remain ongoing matters of debate. This study sought to compare clinical outcomes between patients who underwent robotic-assisted versus conventional PFAs with inlay and onlay prosthetic designs.
Methods
A single-center retrospective review found 237 knees (211 patients) which underwent PFA between 2011 and 2021. One hundred eighty-four knees were included in the final analysis after cases were excluded for having indications other than osteoarthritis or having less than one year of follow-up. There were 90 conventional PFAs and 94 robotic-assisted PFAs performed. Inlay components were implanted in 89 knees and onlay components were implanted in 95 knees. Propensity score matching was utilized to address demographic differences between groups.
Results
Overall, there was a revision-free survivorship rate of 89.7% with an average time to follow-up of 4.6 years (range 1.2 to 11.1). Twenty-nine knees (15.8%) required various non-conversion procedures. The conventional matched cohort exhibited a higher all-cause revision rate, accounting for revision PFAs and conversions to TKA, (18.8 vs. 6.4%, p = 0.014) and a shorter mean time to revision than the robotic-assisted cohort (3.1 vs. 5.8 years, p = 0.026). A Kaplan–Meier survivorship curve showed differences between the conventional and robotics cohorts (p = 0.041). All revisions following robotic-assisted PFA were caused by progression of osteoarthritis, whereas conventional PFAs also required revision due to aseptic loosening and patellar maltracking. The rate of infection resulting in irrigation and debridement was higher for conventional cases (4.3 vs. 0%, p = 0.041). No significant differences in clinical outcomes between the inlay and onlay prosthetic design matched cohorts were identified.
Conclusion
PFA is an effective treatment for addressing advanced patellofemoral arthritis. Robotic-assisted surgery may lead to improved clinical outcomes.
Level of evidence
III.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38492064</pmid><doi>10.1007/s00402-024-05263-z</doi><tpages>12</tpages></addata></record> |
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| subjects | Adult Aged Arthroplasty, Replacement, Knee - methods Clinical outcomes Female Humans Joint surgery Knee Arthroplasty Knee Prosthesis Male Medicine Medicine & Public Health Middle Aged Orthopedics Osteoarthritis Osteoarthritis, Knee - surgery Patellofemoral Joint - surgery Prostheses Prosthesis Design Reoperation - statistics & numerical data Retrospective Studies Robotic Surgical Procedures - methods Robotics Treatment Outcome |
| title | Clinical outcomes of patellofemoral arthroplasty: robotic assistance produces superior short and mid-term outcomes |
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