• Hany Elbardesy, André McLeod, Rehan Gul, and James Harty.
• Department of Trauma and Orthopaedic Surgery, Cork University Hospital, Wilton, Cork, Ireland. hany.elbardesy@ucdconnect.ie.
• Arch Orthop Trauma Surg. 2022 May 1; 142 (5): 851-859.

BackgroundBoth Patellofemoral Arthroplasty (PFA) and Total Knee Arthroplasty (TKA) are accepted surgical options for end-stage isolated patellofemoral osteoarthritis (PFOA). We performed a systematic review and meta-analysis to compare outcomes of PFA and TKA by evaluation of the patient-reported outcome measures (PROMs).MethodsWe systematically identified publications reporting on patients that underwent either TKA or modern PFA for isolated PFOA. Meta-analysis software was used to screen for potential articles with at least two years' follow-up. Data were extracted and analysed for all PROMs operating time, postoperative inpatient time, complications and cost. We included five studies in our cumulative meta-analysis and reviewed them using Review Manager V.5.0. We computed the risk ratio as a measure of the treatment effect, taking into account heterogeneity. We used random-effect models.ResultsNo significant difference was found between both TKA and PFA in the context of operating time. No significant difference after five years' follow-up was found between the two treatment options in terms of UCLA score and patient satisfaction. PFA showed significant improvement in WOMAC score at five-year follow-up, less postoperative inpatient time, better cost-effectiveness and significantly less blood loss.ConclusionPFA seems to be a viable alternative to TKA for treatment of isolated PFOA in appropriately selected patients. PFA showed less postoperative inpatient time and blood loss with similar PROMs to the TKA. Moreover, it is an economically beneficial joint-preserving procedure.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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