BLOG: Considerations for patellofemoral joint preservation vs patellofemoral arthroplasty
Patellofemoral Update, a blog sponsored by The Patellofemoral Foundation features a bylined post by Sabrina M. Strickland, MD, sports medicine surgeon at HSS, to discuss considerations for patellofemoral joint preservation versus patellofemoral arthroplasty.
Dr. Strickland wrote there are many options for treatment of patellofemoral arthritis, and the first step is to determine if patients have undergone adequate physical therapy (PT), noting a good patellofemoral PT program should help the patient get stronger, teach them effective ways to strengthen the quad without overloading the patellofemoral joint and perhaps, help them unlearn their compensatory behaviors that lead to other aches and pains.
Dr. Strickland said there are several options available for the younger patient with significant symptomatic chondromalacia, once they have failed PT and injections. “For the classic overloader with lateral patellar tilt, perhaps slight valgus and an elevated Q-angle, an anteromedializing tibial tubercle osteotomy can improve patellar tracking and decrease the contact stress at the lateral facet of the patella. In patients with chondral lesions of 2 cm2 and more, a cartilage restoration procedure can provide pain relief and reduce stress on the subchondral bone,” she cited.
Dr. Strickland concludes the decision on whether to consider a patellofemoral arthroplasty (PFJ) can be difficult in patients between the ages of 40 and 50 years and is determined by the extent of chondral wear. In patients older than 50 years of age, a PFJ is the best option in almost all cases.
Read the full article at Healio.com.