Photograph of a trochlear implant replacing the bony trochlear groove.
X-ray from the side, showing how the implant is anchored.
What is the trochlea?
The trochlea is the groove in the femur bone where the patella or kneecap makes contact and slides as the knee bends and straightens.
An abnormal trochlear groove may lead to altered forces in and around the kneecap, with pain at the front of the knee and eventual patello-femoral arthritis.
Quick linksWho gets isolated trochlear (patellofemoral) arthritis?
Arthritis restricted to the area of contact between the patella and the trochlear groove occurs in three general groups -
- Patients over 60 who are overweight
- Younger patients who have a history of kneecap instability, such as dislocation
- Patients who have previously suffered a fracture of the kneecap
Quote from peer-reviewed paper:
"...there is ample debate whether younger patients should undergo PFA [patellofemoral arthroplasty] or TKA [total knee arthroplasty] in this setting. Common arguments in favor of PFA are that it is believed to be a quicker procedure and recovery, more bone sparing with more optimal postoperative knee kinematics and that it is technically not challenging to revise to a TKA when needed."
Citation: Hoogervorst P, Arendt EA. Patellofemoral arthroplasty: expert opinion. J Exp Orthop. 2022 Mar 4;9(1):24. doi: 10.1186/s40634-022-00457-z. PMID: 35244809; PMCID: PMC8897539.
Will a trochlear implant avoid total knee replacement?
A trochlear implant may be indicated in the active adult where the trochlear joint cartilage is damaged but the cartilage at the ends of the rounded femoral condyles is still good.
The ligaments and menisci are left intact. The implant may avoid further deterioration of the joint and the need for a later total knee replacement, but the a knee replacement is still possible if it becomes indicated.
Forum discussions
- Three options...but which one?
A discussion about patellofemoral joint replacement as an alternative to other surgical means of managing isolated damage to the patellofemoral joint.
- Recovery time for a patellofemoral replacement????
The general consensus is that recovery time is much sooner than for total knee replacement