Development and evaluation of a minimally aggressive method of patellofemoral osteoarthritis surgical treatment

Purpose: The purpose of this study was to assess the impact of developed minimally invasive operation such as the partial lateral facetectomy (PLFE) with patella thickness resection in patients with lateral patellofemoral (PF) osteoarthritis on short-term clinical and radiographic outcomes. Methods: This is a prospective study of 27 knees in 27 patients (18 females and 9 males, mean aged at surgery 59.1-year old) whom a PLFE with patella thickness resection using developed minimally invasive method was performed. Data of preoperative and postoperative questionnaires, physical examinations, and radiographs were analyzed. The minimum follow-up was 12 months (mean, 24.1 months; range, 12-36 months). Results: The subjective outcomes included the anterior pain relief assessed by scores using the Western Ontario and McMaster Universities Arthritis Index score (scores improved considerably by 2.34 points with respect to pain and by 1.63 points with respect to function), visual analog scale, and Knee Society Score (that improved in 78% of the knees). The majority of these patients experienced improvement in their PF symptoms. The PF index decreased considerably after surgery. The mean patellar width and thickness were decreased after surgery, maintaining a width/thickness ratio of 1.8:1.0 after surgery. Conclusion: PLFE with patella thickness resection aiming to decrease the high pressure in the lateral facet and improving congruence of the patella confirmed frequent pain relief. This surgical procedure is minimally invasive, relatively simple, and effective in selected patients and can be a valid early alternative to more complex operations. Level of Evidence: Level IV Therapeutic study.