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synonyms: patellofemoral arthritis, patellofemoral DJD, patellofemoral osteoarthritis
Patellofemoral Arthritis ICD-10
Patellofemoral Arthritis ICD-9
- 715.16 (osteoarthrosis, localized, primary; lower leg)
Patellofemoral Arthritis Etiology / Epidemiology / Natural History
- occurs in 32.7% of men and 36.1% of women older than 60 years. (Davies AP, CORR 2002;402:206)
- most often involves the lateral facet of the patella, suggesting that malalignment is a significant influence on PF arthritis.
Patellofemoral Arthritis Anatomy
- primary soft-tissue static stabilizers of PF joint are the medal and lateral patellofemoral and patellotibial complexes
- Patellofemoral mechanics are dependent on a complex orchestration of factors including: patellar anatomy, trochlear groove anatomy, soft-tissue stabilizers, extensor mechanism strenght and funtion, limb alignment
Patellofemoral Arthritis Clinical Evaluation
- Anterior knee pain, dull aching. Worse with stairs and prolonged sitting.
Patellofemoral Arthritis Xray / Diagnositc Tests
- A/P and lateralknee
- 45 ° posterioanterior flexion weight-bearing (Rosenberg)
- Merchant/ Skyline view
- MRI
Patellofemoral Arthritis Classification / Treatment
- Inferior Pole
- Lateral Facet
- Medial Facet
- Proximal Pole or diffue lesions
- Patellofemoral brace
- Patellofemoral arthroplasty (Kooijman HJ, JBJS 2003;85B:836)
- Lateral release: Patient satsifaction= 33% very satisfied, 26% satisfied, 41% dissatisfied. (Aderinto J, Arthroscopy 2002;18:399)Indicated for patients with tight lateral retinaculum, patellar tilt on xray, mainly patellofemoral pain and no history of instability. Any lateral patellar facet osteophyte should be removed during surgery. Generally considered limited goals surgery that may be precursor to more definitive intervention.
- Tibial Tubercle Transfer:
- TKA (Dalury DF, J Knee Surg 2005;18:274).
Patellofemoral Arthritis Associated Injuries / Differential Diagnosis
Patellofemoral Arthritis Complications
- Infection
- DVT/PE
- Progressive arthritis
Patellofemoral Arthritis Follow-up Care
Patellofemoral Arthritis Review References
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