José Arteaga CorreaA, Eduardo Poblete Durruty, Fernando Martin Kommer, Gabriel Domecq de Bobadilla, David Figueroa Poblete
{"title":"髌股关节成形术后恢复运动和娱乐活动:系统回顾。","authors":"José Arteaga CorreaA, Eduardo Poblete Durruty, Fernando Martin Kommer, Gabriel Domecq de Bobadilla, David Figueroa Poblete","doi":"10.1016/j.jisako.2025.100925","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>Patellofemoral arthroplasty (PFA) is an established treatment for isolated patellofemoral osteoarthritis. However, evidence regarding postoperative activity levels and return to sport (RTS) remains limited.</p><p><strong>Objective: </strong>To evaluate RTS and recreational activity rates following PFA, identify factors influencing these outcomes, and report associated complications.</p><p><strong>Evidence review: </strong>A systematic search was conducted in June 2024 across PubMed, EMBASE, ScienceDirect, and Scopus, following PRISMA guidelines. Search terms included variations of \"patellofemoral arthroplasty,\" \"physical activity,\" and \"return to sport.\" Studies were included if they reported RTS outcomes following PFA. Studies lacking RTS data or isolated PFA results were excluded. From 492 records, 7 studies met the inclusion criteria.</p><p><strong>Findings: </strong>Seven studies (2 prospective, 5 retrospective) comprising 265 patients (281 knees; 64.6% women; mean age 48.9 years) were included, with a mean follow-up of up to 5.3 years. RTS definitions varied, with reported rates ranging from 64.7% to 91%. Low-impact sports were more commonly resumed, and 58.6% of patients returned to sport within six months. Among those who returned, 74.8% reached or exceeded their preoperative activity level. Postoperative pain improved (VAS from 6.3 to 2.7), although up to 38.6% of patients reported pain limiting activity. Conversion to total knee arthroplasty occurred in 6.3% to 13% of cases, and reoperation rates ranged from 10.4% to 25%. Limitations included inconsistent RTS definitions, heterogeneous outcome reporting, and use of non-standardized questionnaires.</p><p><strong>Conclusions: </strong>Return to sport and recreational activity after PFA can be resumed by most patients, especially low-impact activities. Pain management should be actively addressed. High-quality studies with standardized RTS definitions are needed to evaluate the long-term impact of activity on implant survival.</p><p><strong>Relevance: </strong>RTS after PFA is safe and achievable. A personalized approach is essential to optimize RTS and manage patient expectations.</p><p><strong>Evidence level: </strong>III.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"100925"},"PeriodicalIF":2.7000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Return to sports and recreational activities after patellofemoral arthroplasty: A systematic review.\",\"authors\":\"José Arteaga CorreaA, Eduardo Poblete Durruty, Fernando Martin Kommer, Gabriel Domecq de Bobadilla, David Figueroa Poblete\",\"doi\":\"10.1016/j.jisako.2025.100925\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>Patellofemoral arthroplasty (PFA) is an established treatment for isolated patellofemoral osteoarthritis. However, evidence regarding postoperative activity levels and return to sport (RTS) remains limited.</p><p><strong>Objective: </strong>To evaluate RTS and recreational activity rates following PFA, identify factors influencing these outcomes, and report associated complications.</p><p><strong>Evidence review: </strong>A systematic search was conducted in June 2024 across PubMed, EMBASE, ScienceDirect, and Scopus, following PRISMA guidelines. Search terms included variations of \\\"patellofemoral arthroplasty,\\\" \\\"physical activity,\\\" and \\\"return to sport.\\\" Studies were included if they reported RTS outcomes following PFA. Studies lacking RTS data or isolated PFA results were excluded. From 492 records, 7 studies met the inclusion criteria.</p><p><strong>Findings: </strong>Seven studies (2 prospective, 5 retrospective) comprising 265 patients (281 knees; 64.6% women; mean age 48.9 years) were included, with a mean follow-up of up to 5.3 years. RTS definitions varied, with reported rates ranging from 64.7% to 91%. Low-impact sports were more commonly resumed, and 58.6% of patients returned to sport within six months. Among those who returned, 74.8% reached or exceeded their preoperative activity level. Postoperative pain improved (VAS from 6.3 to 2.7), although up to 38.6% of patients reported pain limiting activity. Conversion to total knee arthroplasty occurred in 6.3% to 13% of cases, and reoperation rates ranged from 10.4% to 25%. Limitations included inconsistent RTS definitions, heterogeneous outcome reporting, and use of non-standardized questionnaires.</p><p><strong>Conclusions: </strong>Return to sport and recreational activity after PFA can be resumed by most patients, especially low-impact activities. Pain management should be actively addressed. High-quality studies with standardized RTS definitions are needed to evaluate the long-term impact of activity on implant survival.</p><p><strong>Relevance: </strong>RTS after PFA is safe and achievable. A personalized approach is essential to optimize RTS and manage patient expectations.</p><p><strong>Evidence level: </strong>III.</p>\",\"PeriodicalId\":36847,\"journal\":{\"name\":\"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine\",\"volume\":\" \",\"pages\":\"100925\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-07-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jisako.2025.100925\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.jisako.2025.100925","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Return to sports and recreational activities after patellofemoral arthroplasty: A systematic review.
Importance: Patellofemoral arthroplasty (PFA) is an established treatment for isolated patellofemoral osteoarthritis. However, evidence regarding postoperative activity levels and return to sport (RTS) remains limited.
Objective: To evaluate RTS and recreational activity rates following PFA, identify factors influencing these outcomes, and report associated complications.
Evidence review: A systematic search was conducted in June 2024 across PubMed, EMBASE, ScienceDirect, and Scopus, following PRISMA guidelines. Search terms included variations of "patellofemoral arthroplasty," "physical activity," and "return to sport." Studies were included if they reported RTS outcomes following PFA. Studies lacking RTS data or isolated PFA results were excluded. From 492 records, 7 studies met the inclusion criteria.
Findings: Seven studies (2 prospective, 5 retrospective) comprising 265 patients (281 knees; 64.6% women; mean age 48.9 years) were included, with a mean follow-up of up to 5.3 years. RTS definitions varied, with reported rates ranging from 64.7% to 91%. Low-impact sports were more commonly resumed, and 58.6% of patients returned to sport within six months. Among those who returned, 74.8% reached or exceeded their preoperative activity level. Postoperative pain improved (VAS from 6.3 to 2.7), although up to 38.6% of patients reported pain limiting activity. Conversion to total knee arthroplasty occurred in 6.3% to 13% of cases, and reoperation rates ranged from 10.4% to 25%. Limitations included inconsistent RTS definitions, heterogeneous outcome reporting, and use of non-standardized questionnaires.
Conclusions: Return to sport and recreational activity after PFA can be resumed by most patients, especially low-impact activities. Pain management should be actively addressed. High-quality studies with standardized RTS definitions are needed to evaluate the long-term impact of activity on implant survival.
Relevance: RTS after PFA is safe and achievable. A personalized approach is essential to optimize RTS and manage patient expectations.