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Arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis.

Zhao G, Liu Y, Yuan B, Shen X, Qu F, Wang J, Qi W, Zhu J, Liu Y - Chin. Med. J. (2015)

Bottom Line: A total of 149 cases were successfully followed up for 14.8 months, on average.This procedure was highly effective for patients with cartilage defects I-III but not for patients with cartilage defect IV.For PFOA patients, this procedure is effective for significantly relieving anterior knee pain, improving knee joint function and quality of life, and deferring arthritic progression.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Chinese People's Liberation Army General Hospital, Beijing 100853, China.

ABSTRACT

Background: Patellofemoral osteoarthritis commonly occurs in older people, often resulting in anterior knee pain and severely reduced quality of life. The aim was to examine the effectiveness of arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis (PFOA).

Methods: A total of 156 PFOA patients (62 males, 94 females; ages 45-81 years, mean 66 years) treated in our department between September 2012 and March 2013 were involved in this study. Clinical manifestations included recurrent swelling and pain in the knee joint and aggravated pain upon ascending/descending stairs, squatting down, or standing up. PFOA was treated with arthroscopic patelloplasty and circumpatellar denervation. The therapeutic effects before and after surgery were statistically evaluated using Lysholm and Kujala scores. The therapeutic effects were graded by classification of the degree of cartilage defect.

Results: A total of 149 cases were successfully followed up for 14.8 months, on average. The incisions healed well, and no complications occurred. After surgery, the average Lysholm score improved from 73.29 to 80.93, and the average Kujala score improved from 68.34 to 76.48. This procedure was highly effective for patients with cartilage defects I-III but not for patients with cartilage defect IV.

Conclusions: For PFOA patients, this procedure is effective for significantly relieving anterior knee pain, improving knee joint function and quality of life, and deferring arthritic progression.

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Related in: MedlinePlus

Preoperative and postoperative magnetic resonance imaging examination comparison chart. Axial patellar osteophytes were cleared, and the joint space increased.
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Figure 3: Preoperative and postoperative magnetic resonance imaging examination comparison chart. Axial patellar osteophytes were cleared, and the joint space increased.

Mentions: All procedures in this group were performed by one highly-qualified orthopedic surgeon. Under local anesthesia, the surgical sites were disinfected and draped according to standard procedures, and the arthroscopy was approached from inside and outside of the knee eyes. Comprehensive detection was first conducted to assess the patellar trajectory and patellofemoral articular cartilage degeneration and to classify the cartilage defect. Next, the hyperplastic synovium, medial and lateral compartments, and lesions in the intercondylar fossa were cleared. The lateral patellar retinaculum was released under radio frequency, and the circumpatella was denervated [Figures 2 and 3]. Under arthroscopy, the surgeon observed the patellar trajectory, the bone blockage and cartilage wound margins affecting patellofemoral joint activities, and the osteophytes present around the ground patella. The aseptic dressing was applied externally, followed by bandaging with elastic bandages. The intraoperative photos and videos were saved.


Arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis.

Zhao G, Liu Y, Yuan B, Shen X, Qu F, Wang J, Qi W, Zhu J, Liu Y - Chin. Med. J. (2015)

Preoperative and postoperative magnetic resonance imaging examination comparison chart. Axial patellar osteophytes were cleared, and the joint space increased.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837825&req=5

Figure 3: Preoperative and postoperative magnetic resonance imaging examination comparison chart. Axial patellar osteophytes were cleared, and the joint space increased.
Mentions: All procedures in this group were performed by one highly-qualified orthopedic surgeon. Under local anesthesia, the surgical sites were disinfected and draped according to standard procedures, and the arthroscopy was approached from inside and outside of the knee eyes. Comprehensive detection was first conducted to assess the patellar trajectory and patellofemoral articular cartilage degeneration and to classify the cartilage defect. Next, the hyperplastic synovium, medial and lateral compartments, and lesions in the intercondylar fossa were cleared. The lateral patellar retinaculum was released under radio frequency, and the circumpatella was denervated [Figures 2 and 3]. Under arthroscopy, the surgeon observed the patellar trajectory, the bone blockage and cartilage wound margins affecting patellofemoral joint activities, and the osteophytes present around the ground patella. The aseptic dressing was applied externally, followed by bandaging with elastic bandages. The intraoperative photos and videos were saved.

Bottom Line: A total of 149 cases were successfully followed up for 14.8 months, on average.This procedure was highly effective for patients with cartilage defects I-III but not for patients with cartilage defect IV.For PFOA patients, this procedure is effective for significantly relieving anterior knee pain, improving knee joint function and quality of life, and deferring arthritic progression.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Chinese People's Liberation Army General Hospital, Beijing 100853, China.

ABSTRACT

Background: Patellofemoral osteoarthritis commonly occurs in older people, often resulting in anterior knee pain and severely reduced quality of life. The aim was to examine the effectiveness of arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis (PFOA).

Methods: A total of 156 PFOA patients (62 males, 94 females; ages 45-81 years, mean 66 years) treated in our department between September 2012 and March 2013 were involved in this study. Clinical manifestations included recurrent swelling and pain in the knee joint and aggravated pain upon ascending/descending stairs, squatting down, or standing up. PFOA was treated with arthroscopic patelloplasty and circumpatellar denervation. The therapeutic effects before and after surgery were statistically evaluated using Lysholm and Kujala scores. The therapeutic effects were graded by classification of the degree of cartilage defect.

Results: A total of 149 cases were successfully followed up for 14.8 months, on average. The incisions healed well, and no complications occurred. After surgery, the average Lysholm score improved from 73.29 to 80.93, and the average Kujala score improved from 68.34 to 76.48. This procedure was highly effective for patients with cartilage defects I-III but not for patients with cartilage defect IV.

Conclusions: For PFOA patients, this procedure is effective for significantly relieving anterior knee pain, improving knee joint function and quality of life, and deferring arthritic progression.

Show MeSH
Related in: MedlinePlus