Patellofemoral Joint Replacement
A targeted procedure to replace the patellofemoral joint and relieve front-of-knee pain
The patellofemoral joint consists of the patella (kneecap) and the trochlear groove at the end of the femur. Over time, arthritis or injury can lead to damage in this joint, causing pain, stiffness, and difficulty with activities like climbing stairs or kneeling.
Common Reasons for Patellofemoral Joint Replacement Surgery
- Isolated patellofemoral arthritis that has not responded to non-surgical treatments.
- Chronic pain or difficulty with activities involving knee bending or weight-bearing.
- Trauma or damage leading to severe degeneration of the kneecap joint.
Goals of the Procedure:
- Reduce pain and stiffness in the kneecap joint.
- Restore mobility and function for daily activities.
- Delay or prevent the need for a total knee replacement.
Preparation for Surgery
Preparation involves a thorough evaluation to confirm the suitability of the procedure and optimise outcomes.
Key Steps in Preparation:
- Pre-Surgical Assessment: Includes a detailed medical history, physical examination, and imaging studies (e.g., X-rays or MRI) to assess the condition of the patellofemoral joint.
- Medication Review: Some medications, particularly blood thinners, may need to be paused.
- Lifestyle Adjustments: Quitting smoking and following a healthy diet can improve healing and recovery.
- Preoperative Instructions: Fasting and preparation guidelines will be provided prior to surgery.
What Happens During the Surgery?
Patellofemoral joint replacement surgery is performed under general or regional anaesthesia, with the procedure typically lasting 1 to 2 hours.
Surgical Steps:
- Incision and Exposure: An incision is made at the front of the knee to access the patellofemoral joint.
- Preparation of the Joint: Damaged cartilage and bone in the kneecap and trochlear groove are carefully removed.
- Placement of Prosthetic Components: Customised implants are positioned to replicate the natural anatomy and function of the joint.
- Closure: The incision is closed with sutures or staples, and the knee is bandaged.
Understanding the Risks
While patellofemoral joint replacement is generally safe, as with any surgery, it carries some risks.
Common Risks:
- Infection at the surgical site.
- Blood clots in the legs or lungs.
- Persistent pain or stiffness in the knee.
Rare but Serious Risks:
- Loosening or wear of the prosthetic components.
- Fracture of surrounding bone.
- Allergic reaction to the implant materials.
Dr Ben McGrath employs advanced surgical techniques and thorough preoperative planning to minimise these risks.
What to Expect After Surgery
Immediate Post-Operative Care:
- Pain is managed using prescribed medications and regular icing.
- Patients may require a knee brace or crutches to support the joint during initial recovery.
- A brief hospital stay (1–2 days) is typically required.
Discharge Instructions:
- Guidance on wound care and recognising signs of complications.
- Recommendations for safe movement and weight-bearing restrictions.
Rehabilitation and Recovery
Rehabilitation is essential to restore strength, mobility, and function in the knee.
Phase 1: Early Recovery (Weeks 0–6)
- Activities: Gentle range-of-motion exercises and non-weight-bearing movements.
- Goal: Minimise swelling and protect the joint.
Phase 2: Intermediate Recovery (Weeks 6–12)
- Activities: Gradual introduction of weight-bearing activities and strength-building exercises under the guidance of a physiotherapist.
- Goal: Improve stability and mobility.
Phase 3: Advanced Recovery (Months 3–6)
- Activities: Functional training and low-impact exercises.
- Goal: Return to regular daily activities and improved quality of life.
Long-Term Outcomes
Patellofemoral joint replacement may provide long-lasting relief from pain and improved mobility. Key factors influencing outcomes include:
- Adherence to post-operative physiotherapy and activity recommendations.
- Regular follow-up visits with Dr McGrath to monitor progress.
- Maintenance of a healthy lifestyle to support joint health.
While many patients experience significant improvements, outcomes may vary based on individual circumstances and the extent of joint damage.