Design, operative technique and ten-year results of the Hermes™ patellofemoral arthroplasty

Recently, increased interest has developed for patellofemoral arthroplasty as treatment for isolated patellofemoral arthritis. However, there are very few reports of the experience with the modern generation of patellofemoral arthroplasties. The new patellofemoral arthroplasty Hermes design is described. The design and technique of insertion are detailed. The indications were isolated patellofemoral disease with advanced arthritic damage. Ten-year followup is available for treatment of 70 knees. Postoperative radiographs of patients were assessed for Oxford deterioration and maltracking of the patella. Tracking was categorised as follows: normal tracking, patellar subluxation, patellar dislocation. There were no late complications attributable to the arthroplasty. Disease progression in the tibiofemoral joint occurred in five patients requiring revision in three of these patients. Persistent anterior knee pain was recorded in four knees. The long-term results using this new design were better than those in the literature that described earlier designs, especially concerning malalignment. Only four knees in four patients had slight lateral patellar subluxation. This implant offers a reasonable alternative to total knee replacement in patients with isolated patellofemoral disease.