Patellofemoral arthroplasty and chondrocalcinosis: a twenty year follow-up.

IF 2.6 3区医学 Q2 ORTHOPEDICS

International Orthopaedics Pub Date : 2025-09-29 DOI:10.1007/s00264-025-06663-5

Philippe Hernigou, Jacques Caton

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Abstract

Purpose: Calcium pyrophosphate dihydrate (CPPD) deposition, often visible radiographically as chondrocalcinosis, frequently accompanies knee osteoarthritis and is usually encountered at the time of arthroplasty. Whether its presence influences the outcome of patellofemoral arthroplasty (PFA) remains uncertain.

Methods: We reviewed 100 PFAs performed in 82 patients between 1997 and 2005, and followed them for an average of 22 years (range, 20-25 years). At surgery, 35 knees showed radiographic chondrocalcinosis, and an additional 33 developed calcification during follow-up.

Results: Fifteen knees (15%) required revision to total knee arthroplasty (TKA) at a mean of 12 years after PFA. The main reasons for revision were tibiofemoral osteoarthritis progression (6 knees), patellar malalignment (7 knees), one implant loosening, and one patella fracture. The 20-year survival rates were 87% for knees without chondrocalcinosis and 90% for those with chondrocalcinosis, with no significant difference in revision timing between groups (log-rank p = 0.64).

Conclusion: Although chondrocalcinosis became more prevalent with age and follow-up, it did not increase the risk of conversion to TKA. These findings suggest that PFA remains a suitable option in carefully selected patients, regardless of the presence of chondrocalcinosis.

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髌股关节置换术和软骨钙化症：20年随访。

目的：焦磷酸钙二水合物（CPPD）沉积，通常在x线上可见为软骨钙化症，常伴膝关节骨关节炎，通常在关节置换术时遇到。其存在是否影响髌骨股骨置换术（PFA）的结果仍不确定。方法：我们回顾了1997年至2005年间82例患者的100例PFAs，并对他们进行了平均22年的随访（范围20-25年）。手术中，35例膝关节显示软骨钙化，另外33例在随访中出现钙化。结果：15个膝关节（15%）在PFA后平均12年需要翻修全膝关节置换术（TKA）。翻修的主要原因是胫股骨关节炎进展（6个膝关节），髌骨错位（7个膝关节），1个植入物松动，1个髌骨骨折。无软骨钙化的膝关节20年生存率为87%，有软骨钙化的膝关节20年生存率为90%，两组间复习时间无显著差异（log-rank p = 0.64）。结论：尽管随着年龄的增长和随访，软骨钙化症变得越来越普遍，但它并没有增加转化为TKA的风险。这些发现表明，在精心挑选的患者中，无论是否存在软骨钙化症，PFA仍然是一个合适的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.