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Purpose <p>Patellofemoral osteoarthritis (PFOA) substantially impairs quality of life, and isolated patellofemoral arthroplasty (PFA) is a surgical option for therapy-refractory symptoms. This study evaluated the clinical and functional outcomes and survivorship of an onlay PFA implant, hypothesizing favourable results in the mid- to long-term follow-up.</p> Methods <p>Between 2009 and 2023, 128 knees (123 patients) with PFOA underwent onlay PFA (Journey™ PFJ, Smith &amp; Nephew) and were retrospectively analyzed. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Short Form-12 (SF-12) and the numerical analog scale (NAS) for pain and function were assessed preoperatively and at the final follow-up. Postoperative complications and revisions were recorded.</p> Results <p>Follow-up data were available for 91 knees (88 patients; mean age 60.7 ± 10.3&#xa0;years) over 6.1 ± 3.4&#xa0;years. Significant improvements in the WOMAC total score (57.3% to 22.5%; <i>p</i> &lt; 0.001), SF-12 physical (29.6 to 43.5; p &lt; 0.001) and mental scores (46.8 to 52.7; <i>p</i> &lt; 0.001), and NAS function (4.7 to 7.2; <i>p</i> &lt; 0.001) and pain (7.8 to 3.1; <i>p</i> &lt; 0.001) were observed. Patients who did not achieve the minimal clinically important difference (MCID) had higher preoperative WOMAC scores (61.3% vs. 46.0%; <i>p</i> = 0.018). The SF-12 mental component summary (MCS) scores was correlated with the pre- and postoperative WOMAC scores (r<sup>2</sup> = 0.21–0.32; <i>p</i> ≤ 0.002). Kaplan–Meier analysis revealed PFA survivorship rates of 89%, 75%, and 67% at five, ten and 15&#xa0;years, respectively.</p> Conclusion <p>Onlay PFA provides significant and sustained improvements in pain, function, and quality of life in patients with PFOA, with satisfactory mid- to long-term implant survivorship. A low preoperative WOMAC score and poor mental health, as indicated by the SF-12 MCS, may be associated with less favourable postoperative outcomes.</p>

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A two to fifteen year follow-up case series of ninety one patients after onlay patellofemoral arthroplasty highlighting the impact of preoperative symptoms and mental health

  • 期刊论文

  • 发表日期：

    2026年1月13日

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  • Felix Zimmermann,
  • Vivien Möck,
  • Paul Alfred Grützner,
  • Emmanouil Liodakis,
  • Peter Balcarek

摘要

Purpose

Patellofemoral osteoarthritis (PFOA) substantially impairs quality of life, and isolated patellofemoral arthroplasty (PFA) is a surgical option for therapy-refractory symptoms. This study evaluated the clinical and functional outcomes and survivorship of an onlay PFA implant, hypothesizing favourable results in the mid- to long-term follow-up.

Methods

Between 2009 and 2023, 128 knees (123 patients) with PFOA underwent onlay PFA (Journey™ PFJ, Smith & Nephew) and were retrospectively analyzed. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Short Form-12 (SF-12) and the numerical analog scale (NAS) for pain and function were assessed preoperatively and at the final follow-up. Postoperative complications and revisions were recorded.

Results

Follow-up data were available for 91 knees (88 patients; mean age 60.7 ± 10.3 years) over 6.1 ± 3.4 years. Significant improvements in the WOMAC total score (57.3% to 22.5%; p < 0.001), SF-12 physical (29.6 to 43.5; p < 0.001) and mental scores (46.8 to 52.7; p < 0.001), and NAS function (4.7 to 7.2; p < 0.001) and pain (7.8 to 3.1; p < 0.001) were observed. Patients who did not achieve the minimal clinically important difference (MCID) had higher preoperative WOMAC scores (61.3% vs. 46.0%; p = 0.018). The SF-12 mental component summary (MCS) scores was correlated with the pre- and postoperative WOMAC scores (r2 = 0.21–0.32; p ≤ 0.002). Kaplan–Meier analysis revealed PFA survivorship rates of 89%, 75%, and 67% at five, ten and 15 years, respectively.

Conclusion

Onlay PFA provides significant and sustained improvements in pain, function, and quality of life in patients with PFOA, with satisfactory mid- to long-term implant survivorship. A low preoperative WOMAC score and poor mental health, as indicated by the SF-12 MCS, may be associated with less favourable postoperative outcomes.