2015 ISAKOS Biennial Congress ePoster #1930

Mid-Term Functional and Radiological Results of a Prospective Study using Oxinium Journey® Patello-Femoral Arthroplasty

Sheethal Prasad Patange Subba Rao, MBBS, MRCS(Eng), Dip in Ortho Engineering, Cardiff, Wales UNITED KINGDOM
Randy Guro, BSc, Bridgend UNITED KINGDOM
Aman Goyal, MBBS, MS, Bridgend UNITED KINGDOM
Amit Pramod Chandratreya, FRCS(Tr&Orth), MS(Orth), MCh(Orth), Cardiff, South Glamorgan UNITED KINGDOM
ABM University Health Board, Princess Of Wales Hospital, Bridgend, Bridgend, Wales, UNITED KINGDOM

FDA Status Not Applicable

Summary: Journey® patellofemoral joint repalcement surgery in our hands has 99% survival at the end of 7 years of follow up, which is better than the results published in the annual NJR 2013 report

Abstract:

Purpose

The purpose of this prospective study was to evaluate early functional and radiological outcome following Journey® (Smith & Nephew, Andover, MA) Patello-femoral arthroplasty

Methods

& RESULTS
90 consecutive patients (62 females, and 28 males) with confirmed isolated patello-femoral arthritis underwent Journey® Patello-femoral arthroplasty performed by a single surgeon between 2007 and March 2014. 89% of patients had an arthroscopy at the time of the surgery to confirm patellofemoral wear. There were no conversions to TKR. A standard medial parapatellar approach and ERAS was used in all patients. 9 patients underwent simultaneous bilateral procedures. All patients were followed up with pre-op and post-op functional outcome measures (Kujala score, Bartlett score, Modified Tegner activity rating scale, SF 12 score and Lysholm score) and regular radiographs. No patient has been lost to follow-up.

The mean age at the time of surgery was 61 years (Range 49-73 years). The mean follow up was 50 months (Range: 6- 70 months). There was significant improvement in Kujala score (38 to 58, p= 0.0007), Bartlett score (14.6 to 21, p=0.0015), Modified Tegner Activity rating scale (2.2 to 3.5, p= 0.0076), SF-12 score (41 to 27, p= <0.0001) and Lysholm score (31 to 69, p=< 0.0001). There were no deep infections, DVT or PE or loss of motion., 10 % of patients required lateral release and medial reefing at the time of primary procedure. There has been no disease progression or loosening at time of final follow-up. 1patient has been revised to TKR for recurrent patellar instability and pain, 2 patients has required a further medial reefing and lateral release for clunking and maltracking and , 2 patients needed further arthroscopy to remove peripatellar adhesions and fibrosis. Kaplan- Meier estimates of the probability of the first revision (95% CI) at final follow up was 99%, as compared to 17.52 %v overall revision rates at final follow up on the 2013 UK NJR report for the same prosthesis.

Conclusion

These results show that the , Mid-term results following Journey® Patellofemoral arthroplasty are very promising in carefully selected group of patients with isolated patello-femoral degenerative disease due to perceived advantages of a unique and asymmetrical geometric design which helps with patellar tracking; and the use of advanced bearing surface which may reduce the long term wear. So far, we haven’t encountered any early failures and will continue the long term follow up of these patients. Our results are better that the published National Joint Registry Data for all Patellofemoral joint repalcements done in United Kingdom in the 2013 annual report.