Special orthopaedic geriatrics (SOG) - a new multiprofessional care model for elderly patients in elective orthopaedic surgery: a study protocol for a prospective randomized controlled trial of a multimodal intervention in frail patients with hip and knee

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors declare that they have no competing interests. 6. J ISAKOS. 2024 Aug;9(4):822-828. doi: 10.1016/j.jisako.2024.01.003. Epub 2024 Jan 5. Patello-femoral arthroplasty- indications and contraindications. Batailler C(1), Libert T(2), Oussedik S(3), Zaffagnini S(4), Lustig S(2). Author information: (1)Orthopaedic Department, Lyon North University Hospital, Hôpital de La Croix Rousse, Hospices Civils de Lyon, 103 Grande Rue de la Croix Rousse, 69004, Lyon, France. Electronic address: cecile.batailler@chu-lyon.fr. (2)Orthopaedic Department, Lyon North University Hospital, Hôpital de La Croix Rousse, Hospices Civils de Lyon, 103 Grande Rue de la Croix Rousse, 69004, Lyon, France. (3)University College London Hospitals NHS Foundation Trust, NW1 2PG, London, UK. (4)IIa Clinica Ortopedicae Traumatologica, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy. Patellofemoral arthroplasty (PFA) is emerging as an attractive alternative to total knee arthroplasty (TKA) for isolated patellofemoral-osteoarthritis (PF-OA) for selected patients. The success of PFA is highly dependent on patient selection. This intervention is still burdened with a higher rate of revisions and a lower survival rate than TKA when the indications or the surgical technique are not optimal. We highlight the indications and contraindications of PFA to obtain satisfying functional outcomes and survivorship. Preoperative clinical and radiological assessment is critical to determine the presence of PFA indications, the absence of contraindications and the necessity of any associated procedures, particularly for the tibial tubercle. The typical indications are patients with isolated symptomatic PF-OA, with trochlear dysplasia, when bone-on-bone Iwano 4 osteoarthritis is observed, without significant malalignment and with the absence of risk factors for developing progressive tibiofemoral-OA. The three main causes of isolated PF-OA are primary OA, trochlear dysplasia and posttraumatic OA following patellar fracture. Trochlear dysplasia is the preferred indication for PFA. Lack of experience with arthroplasty or realignment of the extensor mechanism is a relative contraindication to performing PFA. Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jisako.2024.01.003