Patellofemoral arthroplasty (PFA) is an attractive option for patients who have isolated patellofemoral disease with the goal of reproducing normal joint function and kinematics while relieving pain, preserving the tibiofemoral joint, and providing longevity.
Outcomes of many different implants and techniques, ranging from first-generation inlay design, to second-generation on lay design and now robotic or navigated techniques, have been described in the literature with mixed results.
Elizabeth C. Bond et al conducted a study to assess the functional outcomes and revision rates of primary PFA with a third-generation implant with short- to medium-term follow-up.
The authors retrospectively reviewed the records of 49 patients (70 knees) undergoing PFA with the iBalance system by a single surgeon at a quaternary center for demographic and surgical data, as well as complications and revision rates. Patient-reported outcome scores were then collected.
Key findings of the study were:
• The population was majority female (81.6%) with a median age of 50 years.
• Four knees were revised to a total knee arthroplasty (5.7%) at an average time point of 2.3 years postoperatively (range: 1.3-3.5 years).
• The median Single Assessment Numeric Evaluation score at the time of follow-up was 82.5, while the median Kujala score was 72.
• Lower preoperative Kellgren-Lawrence grade was significantly associated with lower Knee Injury and Osteoarthritis Outcome Scores in all 5 domains (P < .05 for all).
• Additional procedures were required in 17 knees (24.3%), in most cases to improve patella tracking.
The authors concluded - “This study is, to our knowledge, the first to examine the short term outcome of the iBalance PFA system. The results show favorable PROs in this group consistent with other 2nd and 3rd generation PFA implants along with a revision rate similar to its prosthetic peers. We plan to continue following our patients in order to report longer-term outcomes of this system.”
Further reading:
Outcomes After Patellofemoral Arthroplasty with the Arthrex iBalance - A Third Generation Implant
Elizabeth C. Bond et al
Arthroplasty Today 33 (2025) 101666
https://doi.org/10.1016/j.artd.2025.101666
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