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Anyone have experience with patellofemoral arthroscopy (PFA)?

Posted by projfan @projfan, Mar 19 8:40am

I'm seeing a surgeon in early April for a second opinion on a total knee replacement, and I'm thinking about discussing a patellofemoral arthroscopy (PFA) with him. I'm expecting pushback, because it apparently has a higher risk of revision, which surgeons see as a blot on their performance statistics, which means they don't like to do them, which means they have less experience with them. Also, of course, it doesn't fix the entire problem, so they are used to worrying that you will eventually need a TKA anyway, which would mean two surgeries rather than one.

But I understand that if successful, they have a faster recovery and leave you with more functionality.

I'm 72, have a somewhat complicated medical profile, have bought decades of surgery delay with weight loss, PT, injections, etc, and am fully expecting to be dealing with dementia by my 80s, so whichever I choose (the PFA or the TKA) will be the last elective surgery I plan to do.

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JulesE | @julese | Mar 24 11:05am

I’m 72 also and have had bad knees since the 1980’s. Had a right knee open knee for a meniscus tear in 1960’s and bilateral arthroscopic repair of torn meniscus in the 1980’s. Fortunately I’ve always been active and despite having Chondromalacia in both I’ve never had any trouble with my knees. In the scenario you described having had years of knee abuse leading to your current situation it will only progress eventually. Yes the temporary fix might work for a period of time though. Since your doc has had a lot of experience with these types of situations I’d listen to their recommendations and get a second opinion too. You certainly don’t want to be dealing with knee surgery at 80 and the possibility of dementia too. Good luck with your decision.

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