The low contact stress patellofemoral replacement: high early failure rate.

The low contact stress patellofemoral replacement consists of a trochlear component and a modular patellar component which has a metal-backed mobile polyethylene bearing. We present the early results of the use of this prosthesis for established isolated patellofemoral arthritis in 51 consecutive patellofemoral replacements in 35 patients. The mean follow-up was 25 months (5 to 60). The estimated survival rate at three years was 63% (95% confidence interval 47 to 80) with revision as the endpoint and 46% (95% confidence interval 30 to 63) with revision and ongoing moderate or severe pain as the endpoint. The early results of the use of the low contact stress patellofemoral replacement are disappointing with a high rate of revision. We cannot therefore recommend its use.

The correlation between femoral condyle radii and subject height.

In the sagittal plane, the distal femoral condyles can be modeled using anterior and posterior circle segments. The aim of this study was to investigate how the radii of these segments vary with subject height. The MRI scans of 20 male and 20 female knees were analyzed with a computer to extract the radii of each condyle segment. These radii were then correlated with the patient's height. The anteromedial radii ranged from 22.6 to 32.6 mm. The posteromedial radii ranged from 15.4 to 26.3 mm. The anterolateral radii ranged from 19.7 to 30.4 mm. The posterolateral radii ranged from 15.2 to 23.6 mm. The radii had a strong correlation with patient height, with some differences between sexes. Linear regressions of the data yielded equations for estimating condyle radii from height. These radii estimations can be helpful in the clinical assessment of knee movement and treatment outcome.

Suture anchors for treatment of sternoclavicular joint instability.

Instability of the sternoclavicular joint is a difficult problem to treat and can present with gross limitation in activities. Eight sternoclavicular joint stabilization procedures were performed over an 8-year period. The patients' ages ranged from 16 to 48 years (mean, 23.5 years). The indication for stabilization was pain associated with instability of the sternoclavicular joint. The joint was stabilized by use of suture anchors on the manubrium and capsular plication. The functional outcome was evaluated by use of the Constant score and patient-based Oxford Shoulder Questionnaire. At a mean follow-up of 4.5 years (range, 1-7.6 years), none of the patients had instability at the sternoclavicular joint, and all except one had returned to their previous employment. The Oxford score was 16 (range, 12-38). The mean Constant score was 74.88 (range, 33-87). We had only 1 poor result (Constant score of 33). Stabilization of the sternoclavicular joint can safely be performed by use of suture anchors. The technique is recommended for symptomatic sternoclavicular joint instability.