Hi, Im female age 54, severe bilateral patellofemoral arthritis due to maltracking, combination of Q
Hi, Im female age 54, severe bilateral patellofemoral arthritis due to maltracking, combination of Q-angle's 20, hypermobility, tight IT bands, sports overuse.Other compartments mild arthritic changes. Will TKR's ensure patella's track correctly so problem doesnt recur or need Tib Ost & Lat Rel too?
Yes TKR's should address maltracking. Tibial osteotomies will not be required. The problem should not recur.
With patellofemoral arthritis there are 2 surgical options to consider. These are either a patellofemoral (partial knee) replacement or a total knee replacement. The partial replacement is a smaller operation with quicker recovery but a higher rate of redo especially in the hands of surgeons who don't do many.With both operations the components need to be properly aligned and positioned to ensure the patella tracks normally. It is very uncommon to need to perform a tibial tuberosity osteotomy at the same time.
Irrespective of the radiology, it is the symptom complex and the effect it has on life activities which should guide the treatment choice. Pain is the major symptom to be considered. May patients with isolated patellofemoral osteoarthritis are able to walk long distances and have mild symptoms. To be successful, an Isolated patellofemoral arthroplasty requires essentially normal patellofemoral tracking and little arthritis involving the other two compartments. The information provided suggests that a patellofemoral arthroplasty is unlikely to be successful here. If the symptoms - read pain - of the arthritis is significant and non operative treatments have failed, a well positioned total knee replacement is likely to provide great benefit. Tibial osteotomy is very rarely required.