Isolierte Patellofemoralarthrose

Die isolierte Patellofemoralarthrose ist eine komplexe Pathologie. Sie tritt gehäuft bei Frauen über 40 Jahren auf, ist mit einem hohen Leidensdruck verbunden und erfordert eine stadiengerechte Therapie. Die Ursachen einer femoropatellaren Degeneration sind vielfältig. Dieser Beitrag soll eine strukturierte Übersicht zu Symptomatik, Diagnostik und stadiengerechter Therapie der Patellofemoralarthrose liefern.

Abstract

Isolated patellofemoral osteoarthritis is a complex pathology. It occurs frequently in women over 40 years and leads to a high degree of suffering. The causes of femoropatellar degeneration are manifold and require stage-specific therapy. This is very challenging for the treating physician. This article is intended to provide a structured overview of the symptoms, diagnostics and stage-specific therapy of patellofemoral osteoarthritis.

Schlüsselwörter

Patellofemoralarthrose - patellofemoraler Gelenkersatz - Patellofemoralgelenk - patellofemoraler Schmerz - Patella

Keywords

patellofemoral arthrosis - patellofemoral arthroplasty - patellofemoral joint - patellofemoral pain - patella

• Literatur

• 1 Lonner JH. Patellofemoral arthroplasty. Orthopedics 2010; 33: 653
• 2 Hanna F, Wluka AE, Ebeling PR. et al. Determinants of change in patella cartilage volume in healthy subjects. J Rheumatol 2006; 33: 1658-1661
• 3 Hinman RS, Crossley KM. Patellofemoral joint osteoarthritis: an important subgroup of knee osteoarthritis. Rheumatology 2007; 46: 1057-1062
• 4 Donell ST, Glasgow MM. Isolated patellofemoral osteoarthritis. Knee 2007; 14: 169-176
• 5 Keshmiri A, Imhoff AB, Dirisamer F. Patellofemorale Arthrose. Arthroskopie 2020; 33: 441-447
• 6 Frings J, Balcarek P, Tscholl P. et al. Conservative versus surgical treatment for primary patellar dislocation. Dtsch Arztebl Int 2020; 117: 279-286
• 7 Kolb A, Willegger M, Chiari C. et al. Behandlung der Patellainstabilität. Z Orthop Unfall 2022; 160: 463-475
• 8 Vaitl T, Grifka J, Bolm-Audorff U. et al. Patellaformen. Trauma Berufskrankh 2012; 14: 437-438
• 9 Seitlinger G, Beitzel K, Scheurecker G. et al. Das schmerzhafte Patellofemoralgelenk. Orthopäde 2011; 40: 353-370
• 10 Iwano T, Kurosawa H, Tokuyama H. et al. Roentgenographic and clinical findings of patellofemoral osteoarthrosis. With special reference to its relationship to femorotibial osteoarthrosis and etiologic factors. Clin Orthop Relat Res 1990; (252) 190-197
• 11 Seitlinger G, Scheurecker G, Högler R. et al. Tibial tubercle-posterior cruciate ligament distance: a new measurement to define the position of the tibial tubercle in patients with patellar dislocation. Am J Sports Med 2012; 40: 1119-1125
• 12 Biedert RM, Albrecht S. The patellotrochlear index: a new index for assessing patellar height. Knee Surg Sports Traumatol Arthrosc 2006; 14: 707-712
• 13 Laskin RS, van Steijn M. Total knee replacement for patients with patellofemoral arthritis. Clin Orthop Relat Res 1999; (367) 89-95
• 14 Bannuru RR, Osani MC, Vaysbrot EE. et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage 2019; 27: 1578-1589
• 15 Werner S, Arvidsson H, Arvidsson I. et al. Electrical stimulation of vastus medialis and stretching of lateral thigh muscles in patients with patello-femoral symptoms. Knee Surg Sports Traumatol Arthrosc 1993; 1: 85-92
• 16 Ahmed AM, Burke DL, Hyder A. Force analysis of the patellar mechanism. J Orthop Res 1987; 5: 69-85
• 17 Becher C, Pagensteert G, Wagner D. Vorderer Knieschmerz. Arthroskopie 2020; 33: 433-440
• 18 Santos TR, Oliveira BA, Ocarino JM. et al. Effectiveness of hip muscle strengthening in patellofemoral pain syndrome patients: a systematic review. Braz J Phys Ther 2015; 19: 167-176
• 19 Lun V, Meeuwisse WH, Stergiou P. et al. Relation between running injury and static lower limb alignment in recreational runners. Br J Sports Med 2004; 38: 576-580
• 20 Petersen W, Ellermann A, Rembitzki IV. et al. Evaluating the potential synergistic benefit of a realignment brace on patients receiving exercise therapy for patellofemoral pain syndrome: a randomized clinical trial. Arch Orthop Trauma Surg 2016; 136: 975-982
• 21 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie e. V. (DGOU). S2k-Leitlinie Gonarthrose. Registernummer 187–050, Stand: 30.11.2017, gültig bis 29.11.2022 (derzeit in Überarbeitung). Zugriff am 06. November 2023 unter: https://register.awmf.org/de/leitlinien/detail/033–004
• 22 Fransen M, McConnell S, Harmer AR. et al. Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med 2015; 49: 1554-1557
• 23 Golightly YM, Allen KD, Caine DJ. A comprehensive review of the effectiveness of different exercise programs for patients with osteoarthritis. Phys Sportsmed 2012; 40: 52-65
• 24 Lim JY, Tchai E, Jang SN. Effectiveness of aquatic exercise for obese patients with knee osteoarthritis: a randomized controlled trial. PM R 2010; 2: 723-731
• 25 Waller B, Ogonowska-Slodownik A, Vitor M. et al. Effect of therapeutic aquatic exercise on symptoms and function associated with lower limb osteoarthritis: systematic review with meta-analysis. Phys Ther 2014; 94: 1383-1395
• 26 Lake DA, Wofford NH. Effect of therapeutic modalities on patients with patellofemoral pain syndrome: a systematic review. Sports Health 2011; 3: 182-189
• 27 Vickers AJ, Cronin AM, Maschino AC. et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med 2012; 172: 1444-1453
• 28 Corbett MS, Rice SJ, Madurasinghe V. et al. Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis. Osteoarthritis Cartilage 2013; 21: 1290-1298
• 29 Micke O, Ugrak E, Bartmann S. et al. Radiotherapy for calcaneodynia, achillodynia, painful gonarthrosis, bursitis trochanterica, and painful shoulder syndrome – Early and late results of a prospective clinical quality assessment. Radiat Oncol 2018; 13: 71
• 30 Kolb A, Willegger M, Chiari C. et al. Behandlung der Patellainstabilität. Z Orthop Unfall 2021; 160: 463-475
• 31 Ouyang Z, Yang BH, Zhang B. et al. [Arthroscopic denervation of patella combined with microfracture for patellofemoral arthritis]. Zhongguo Gu Shang 2019; 32: 407-411
• 32 Zhao G, Liu Y, Yuan B. et al. Arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis. Chin Med J 2015; 128: 79-84
• 33 Dejour H, Walch G, Nove-Josserand L. et al. Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 1994; 2: 19-26
• 34 McWalter EJ, Cibere J, MacIntyre NJ. et al. Relationship between varus-valgus alignment and patellar kinematics in individuals with knee osteoarthritis. J Bone Joint Surg Am 2007; 89: 2723-2731
• 35 Imhoff AB, Feucht MJ, Meidinger G. et al. Prospective evaluation of anatomic patellofemoral inlay resurfacing: clinical, radiographic, and sports-related results after 24 months. Knee Surg Sports Traumatol Arthrosc 2015; 23: 1299-1307
• 36 Feucht MJ, Cotic M, Beitzel K. et al. A matched-pair comparison of inlay and onlay trochlear designs for patellofemoral arthroplasty: no differences in clinical outcome but less progression of osteoarthritis with inlay designs. Knee Surg Sports Traumatol Arthrosc 2017; 25: 2784-2791
• 37 Benignus C, Meier M, Best R. et al. Wenn nichts mehr geht: Der patellofemorale Gelenkersatz. Sportschaden 2021; 35: 227-233
• 38 Lustig S, Magnussen RA, Dahm DL. et al. Patellofemoral arthroplasty, where are we today?. Knee Surg Sports Traumatol Arthrosc 2012; 20: 1216-1226
• 39 Hernigou P, Caton J. Design, operative technique and ten-year results of the Hermes™ patellofemoral arthroplasty. Int Orthop 2014; 38: 437-442
• 40 Hoogervorst P, de Jong RJ, Hannink G. et al. A 21% conversion rate to total knee arthroplasty of a first-generation patellofemoral prosthesis at a mean follow-up of 9.7 years. Int Orthop 2015; 39: 1857-1864
• 41 Ackroyd CE, Newman JH, Evans R. et al. The Avon patellofemoral arthroplasty: five-year survivorship and functional results. J Bone Joint Surg Br 2007; 89: 310-315
• 42 Cartier P, Sanouiller JL, Khefacha A. Long-term results with the first patellofemoral prosthesis. Clin Orthop Relat Res 2005; 436: 47-54
• 43 Dahm DL, Al-Rayashi W, Dajani K. et al. Patellofemoral arthroplasty versus total knee arthroplasty in patients with isolated patellofemoral osteoarthritis. Am J Orthop 2010; 39: 487-491
• 44 Odgaard A, Madsen F, Kristensen PW. et al. The Mark Coventry Award: patellofemoral arthroplasty results in better range of movement and early patient-reported outcomes than TKA. Clin Orthop Relat Res 2018; 476: 87-100
• 45 Mont MA, Haas S, Mullick T. et al. Total knee arthroplasty for patellofemoral arthritis. J Bone Joint Surg Am 2002; 84: 1977-1981
• 46 O’Donnell T, Neil MJ. The Repicci II® unicondylar knee arthroplasty: 9-year survivorship and function. Clin Orthop Relat Res 2010; 468: 3094-3102