In contrast to total knee replacement, a comprehensive procedure that replaces all three knee compartments (femur, tibia, and patella) with prostheses, patellofemoral joint replacement offers a less invasive surgical alternative. It involves resurfacing the back of the kneecap and the front of the thigh bone, specifically addressing patellofemoral arthritis. While this surgical approach was initially introduced in the 1970s, early designs had limitations. However, advancements in design and materials over the last decade have transformed patellofemoral joint replacement into a reliable treatment option for patellofemoral arthritis, akin to the effectiveness of total knee replacement for patients with generalized knee arthritis. This modern approach enhances the outlook for patients dealing with patellofemoral arthritis, improving their quality of life and mobility.
Diagnosis and Treatment
The diagnosis of patellofemoral arthritis hinges on a combination of factors, including a comprehensive physical examination, a detailed patient history, and advanced imaging techniques. Patients grappling with patellofemoral arthritis commonly present with distinctive symptoms, such as isolated pain in the front of the knee. This discomfort tends to intensify during prolonged periods of sitting, when transitioning from a seated position, or when navigating stairs.
To confirm the diagnosis and assess the extent of the condition, X-rays and MRIs are employed. These diagnostic tools enable healthcare professionals to pinpoint whether arthritis predominantly affects the patellofemoral compartment of the knee. For a considerable number of patients dealing with patellofemoral arthritis, non-operative treatments prove highly effective, resulting in enhanced comfort and mobility.
Patellofemoral joint replacement emerges as a recommendation when these non-surgical approaches fall short in providing relief, and when the patient's quality of life is profoundly impacted. During the procedure, our surgical team adeptly removes the damaged cartilage and a small portion of bone, subsequently replacing them with a high-density plastic patella, often referred to as a patellar button. In addition, any damaged cartilage and a minor bone section from the femoral groove are excised and replaced with a thin metal laminate. The objective here is to restore a gliding joint with minimal friction between the surfaces, enhancing overall joint functionality.
This surgical intervention, which generally takes about an hour, is followed by an overnight stay in the hospital. It is a pivotal step toward alleviating pain and improving mobility, ultimately enhancing the patient's quality of life.
Recovery from Joint Reconstruction
Following the surgical procedure, patients experience a prompt recovery trajectory. They are encouraged to put weight on the operated leg and can start walking with the support of a cane or crutches. Typically, the initiation of physical therapy occurs around one week after the patient returns home.
The timeline for returning to work is contingent on various factors, including the nature of the patient's occupation and their commuting requirements. In general, patients can expect to return to work within a window spanning two to six weeks following their patellofemoral joint replacement. Achieving full recovery from this procedure, which primarily hinges on the restoration of muscle strength and overall joint function, entails a period ranging from six to twelve months. This comprehensive recovery process is pivotal in ensuring that patients regain their mobility and experience a significant enhancement in their quality of life.