High mid-term revision rate after treatment of large, full-thickness cartilage lesions and OA in the patellofemoral joint using a large inlay resurfacing prosthesis: HemiCAP-Wave®

Knee Surg Sports Traumatol Arthrosc. 2017 Dec;25(12):3856-3861. doi: 10.1007/s00167-016-4352-2. Epub 2016 Oct 6.

Abstract

Purpose: The HemiCAP-Wave® implant for the patellofemoral resurfacing treatment of large cartilage lesions and osteoarthritis (OA) was introduced in 2009. The outcome of a prospective cohort study of 18 patients with large trochlea lesions or isolated OA treated with the HemiCAP-Wave® implant is presented with up to a 6-year survival rate, and hypothesised short-to mid-term reduced pain and improved function.

Methods: Indication for treatment with the HemiCAP-Wave® implant was a symptomatic, large cartilage lesion in trochlea demonstrated by MRI or arthroscopy, which was ICRS grades 3-4 and larger than 4 cm2. Patients were followed for 2 years with American Knee Society Subjective outcome Scores (AKSS), pain scores and radiographic evaluations and for up to 6 years with complications and reoperations.

Results: At the 1- and 2-year follow-up mean AKSS clinical score, the mean AKSS function score and mean pain score improved significantly. Within 6 years, 28 % of the implants were revised to arthroplasty due to the progression of cartilage lesions, osteoarthritis or increased knee pain.

Conclusion: The present study demonstrated an improved short- to mid-term clinical outcome and reduced pain but high mid-term revision rate after patellofemoral inlay resurfacing using the HemiCAP-Wave® implant. Patellofemoral resurfacing implantation treatment with a large inlay prosthesis can offer temporary treatment for large isolated patellofemoral cartilage lesions or OA in younger patients with almost healthy cartilage in the other compartments who are not yet eligible for arthroplasty treatment.

Level of evidence: IV.

Keywords: Cartilage defects; Inlay resurfacing arthroplasty; Knee; Osteoarthritis; Patellofemoral joint replacement.

MeSH terms

  • Adult
  • Aged
  • Arthroplasty, Replacement, Knee*
  • Arthroscopy
  • Cartilage / pathology*
  • Cartilage / surgery
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / surgery
  • Knee Prosthesis*
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / surgery*
  • Pain / surgery
  • Patellofemoral Joint / surgery*
  • Prospective Studies
  • Reconstructive Surgical Procedures
  • Reoperation / statistics & numerical data*
  • Treatment Outcome