Arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis

Gang Zhao, Yujie Liu, Bangtuo Yuan, Xuezhen Shen, Feng Qu, Jiangtao Wang, Wei Qi, Juanli Zhu, Yang Liu, Gang Zhao, Yujie Liu, Bangtuo Yuan, Xuezhen Shen, Feng Qu, Jiangtao Wang, Wei Qi, Juanli Zhu, Yang Liu

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.

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Three-dimensional fat-suppressed spoiled gradient recalled echo sequence cartilage sequence magnetic resonance imaging shows that the cartilage on the patella and groove surface degenerated (red arrow), and this degeneration was frequently complicated by slight degeneration in the menisci and tibial joints.
Figure 2
Figure 2
Release of the lateral patellar retinaculum.
Figure 3
Figure 3
Preoperative and postoperative magnetic resonance imaging examination comparison chart. Axial patellar osteophytes were cleared, and the joint space increased.
Figure 4
Figure 4
Circumpatellar nerve distribution schematic diagram.

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