Clin Orthop Surg.  2015 Jun;7(2):171-176. 10.4055/cios.2015.7.2.171.

The Avon Patellofemoral Joint Replacement: Mid-Term Prospective Results from an Independent Centre

• Akhbari P
• Malak T
• Dawson-Bowling S
• East D
• Miles K
• Butler-Manuel PA

• KMID: 2164541
• DOI: http://doi.org/10.4055/cios.2015.7.2.171

Abstract

BACKGROUND
Approximately 10% of patients with osteoarthritis (OA) of the knee have unicompartmental OA confined to the patellofemoral joint (PFJ). The main surgical options are total knee replacement (TKR) and PFJ replacement (PFJR). PFJR has a number of advantages over TKR, including being less invasive, preserving the unaffected parts of the knee, allowing faster recovery and better range of motion and function. We report our prospective mid-term results of the Avon PFJR for established isolated PFJ arthritis in 61 consecutive procedures.
METHODS
Sixty-one Avon PFJRs were performed in 57 patients. The outcome measures were the new Oxford knee score (OKS), Hungerford and Kenna score (HKS), and Crosby Insall knee scores. Only patients with severe isolated PFJ OA were included. The diagnosis was based on a combination of clinical, radiological and, where available, arthroscopic findings.
RESULTS
Mean follow-up was 5.09 years (range, 12 to 124 years). There were 2 revisions in the first 5 years. The median HKS score was 80 (interquartile range, 70 to 95) and the mean OKS was 31.8 (+/- standard deviation, 8.7) at 5 years. These were significantly better (p < 0.001) than the preoperative scores.
CONCLUSIONS
The Avon prosthesis gives good functional outcomes in the medium term and survives well. Our data support other studies in the literature and is the largest independent prospective study to date.

Keyword

Patellofemoral joint; Arthroplasty; Survivorship; Survival rate

MeSH Terms

Aged
*Arthroplasty, Replacement, Knee
Female
Humans
Male
Patellofemoral Joint/*surgery
Prospective Studies
Time Factors
Treatment Outcome

Figure

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  Fig. 1 Box plot showing the distribution of the Hungerford and Kenna score (HKS) over time. This demonstrates an improvement in the HKSs over the first five years. Pre: presurgery.

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  Fig. 2 Distribution of the mean (95% confidence interval) Oxford knee score (OKS) with time. This demonstrates an improvement in the new OKS over the first five years. Pre: presurgery.

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  Fig. 3 Kaplan-Meier survival curve for revision arthroplasty.

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