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[Patellofemoral arthroplasty: indication, technique and results].
[trochlear dysplasia]
Although
patellofemoral
arthroplasty
has
been
used
for
more
than
30
years
,
it
is
still
a
challenging
subject
in
orthopedics
.
The
reason
for
this
are
the
complex
kinematics
of
the
patellofemoral
joint
which
are
influenced
by
dynamic
and
static
factors
.
New
implant
concepts
that
incorporate
multiple
coronal
and
sagittal
curvatures
and
surface
controlled
inlay
implantation
show
a
positive
direction
in
modern
patellofemoral
arthroplasty
.
The
purpose
of
this
work
is
the
review
of
the
literature
on
patellofemoral
arthroplasty
and
the
presentation
of
our
own
experience
.
We
present
indications
and
surgical
techniques
of
patellofemoral
arthroplasty
as
well
as
the
most
important
aspects
of
preoperative
evaluation
.
The
patellofemoral
joint
can
be
reconstructed
using
either
an
inlay
or
an
onlay
prosthesis
.
Both
arthroplasty
concepts
are
discussed
.
Additional
pathologies
like
chronic
patellofemoral
instabilities
due
to
dysplasia
,
valgus
/
varus
or
rotational
malalignment
,
and
soft
-tissue
alterations
are
addressed
with
concomitant
procedures
.
Both
inlay
and
onlay
arthroplasty
have
demonstrated
good
functional
outcome
scores
in
patients
with
patellofemoral
osteoarthritis
.
Patients
with
patellofemoral
instability
and
/
or
trochlear
dysplasia
may
benefit
more
from
patellofemoral
arthroplasty
than
patients
with
primary
osteoarthritis
because
not
only
pain
but
also
secondary
pathologies
are
addressed
.
Patellofemoral
arthroplasty
is
an
effective
and
safe
procedure
if
the
indication
criteria
are
respected
and
the
specific
surgical
technique
is
used
.
However
,
comparative
results
on
current
inlay
and
onlay
prostheses
have
not
been
published
in
the
literature
to
date
.