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Case report
Dislocation of the polyethylene in a patellofemoral replacement with a movable patella
Luxación del polietileno en prótesis patelo-femoral con patela móvil
M.J. Sangüesa Nebot
Corresponding author
mjsanneb@hotmail.com

Corresponding author.
, F. Cabanes Soriano, R. Fernández Gabarda, A. Darder Prats
Servicio de Traumatología y Cirugía Ortopédica, Hospital Arnau de Vilanova de Valencia, Valencia, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Isolated patellofemoral osteoarthritis remains an unsolved problem in degenerative knee pathology&#46; It is radiographically observed in 11&#37; of men and 24&#37; of women over 55 years in whom a radiographic study is conducted due to a symptomatic knee&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> Surgical treatment is reserved for patients with functional failure and severe pain symptoms in whom conservative measures have not been successful&#46; The choice of surgical technique is based on the symptoms&#44; along with objective findings and other factors such as age&#44; level of activity and occupation&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Such procedures include cleaning arthroscopy&#44; osteotomy&#44; osteochondral transplants and patellectomies&#44; all with poor results&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Although in older patients total knee arthroplasty seems the best option&#44; in patients under 55&#8211;60 years with normal tibiofemoral alignment&#44; without signs of patellar subluxation and with reasonable functional expectations&#44; patellofemoral arthroplasty may be considered as a preferable option as it is less invasive and preserves the tibiofemoral joint&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">McKeever created the first design for a patellofemoral prosthesis in 1955&#44; although it was not until the 1970s&#44; with the introduction of the designs by Lubinus and Richard&#44; that their regular use became widespread&#46; In an attempt to improve results&#44; in recent years there has been a renewed interest in patellofemoral arthroplasties which incorporated design changes and enhancements&#44; improved instrumentation for a more accurate surgical technique and an adjustment in the indications&#46; The latest prosthetic design to be introduced has been a patellofemoral prosthesis with mobile polyethylene&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">We report a rare complication&#58; dislocation of polyethylene in the patellar metal base&#46; This is the first case reported in the Spanish literature and the tenth worldwide&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Case report</span><p id="par0020" class="elsevierStylePara elsevierViewall">We describe the case of a 55-year-old woman who attended our service due to persistent bilateral knee pain after undergoing partial medial patellectomy and arthroscopy on her left knee 1 year earlier&#46; Exploration of the left knee&#44; more symptomatic than the right&#44; revealed patellofemoral findings and a range of movement with 10&#176; extension&#46; Radiographic images showed gonarthrosis&#44; mainly of the patellofemoral compartment &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; and a magnetic resonance study revealed a bilateral patellofemoral arthrosic chondropathy&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">In February 2005&#44; the patient underwent a patellofemoral arthroplasty with a left Low Contact Stress &#40;LCS&#41; patellofemoral prosthesis &#40;DePuy&#44; Warsaw&#44; IN&#44; USA&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; She progressed satisfactorily&#44; reporting clinical improvement and personal satisfaction&#46; Two years later&#44; plain radiographs showed no change compared to the initial images and the range of motion was &#8722;5&#176;&#47;130&#176;&#46; Three years after the surgery&#44; radiographic images remained unchanged and the range of motion was 10&#176;&#47;130&#176;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">At 4 years after surgery&#44; the patient consulted due to persistent knee pain without history of trauma and with an evolution of various months&#46; Plain radiographs showed a separation of the polyethylene component from the patellar metal base&#46; According to its markers&#44; the polyethylene was located at the bottom of the external quadricipital recess &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; We considered replacing the partial patellofemoral arthroplasty with a total knee arthroplasty&#46; During surgery&#44; we confirmed that the patellar polyethylene component was dislocated and free within the knee&#46; In addition&#44; discrete metallosis was also observed in the periprosthetic soft tissues&#44; supposedly due to the dislocation and the duration of knee pain&#46; Once removed&#44; the implant showed metal&#8211;metal friction marks&#46; Review surgery was performed using a complete LCS primary prosthesis with rotating platform &#40;DePuy&#44; Warsaw&#44; IN&#44; USA&#41;&#44; without incident and with a good subsequent evolution&#46; Three years after surgery&#44; the patient remained asymptomatic&#44; presented a good range of motion &#40;&#8722;5&#176;&#47;100&#176;&#41; and manifested her satisfaction&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">Different causes of patellofemoral arthropathy require different treatments&#44; with the most common causes being malalignment&#44; dysplasia&#44; instability&#44; trauma&#44; inflammatory arthritis&#44; obesity and osteoarthritis&#46; The choice of treatment is based on the symptoms&#44; on objective findings and on other data such as age&#44; activity and occupation&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> According to Witjes&#44; the best candidates for patellofemoral arthroplasty are patients younger than 55&#8211;60 years with normal tibiofemoral alignment and without signs of patellar subluxation&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">A literature review resulted in the identification of the following contraindications for patellofemoral arthroplasty&#58; first treatment choice being without having tried other conservative options&#44; tibiofemoral joint osteoarthritis&#44; systemic inflammatory joint disease&#44; unevolved patellofemoral osteoarthritis&#44; low patella&#44; instability with patellofemoral misalignment&#44; tibiofemoral mechanical malalignment &#40;more than 5&#176; varus or more than 8&#176; valgus&#41;&#44; active infection&#44; clinical symptoms of complex regional pain and limitation of knee motion &#40;&#8722;10&#176; extension and 110&#176; flexion&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In any case&#44; it should be noted that this literature review was conducted on very few studies&#44; all with a low number of patients and limited available data&#46; The problems leading to failure of a patellofemoral arthroplasty include progression to tibiofemoral osteoarthritis&#44; patellar pain&#44; subluxation due to poor balance of soft parts&#44; poor surgical technique with malposition of the components and design problems&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Most current patellofemoral arthroplasty designs are based on total knee arthroplasty patellofemoral designs with certain modifications such as intramedullary instrumentation&#44; a greater range of sizes&#44; providing compatibility of the patellar prosthesis with total review arthroplasty&#44; a minimal incision&#44; improved cementing techniques and better polyethylene materials&#44; a superolateral extension of the trochlear ridge to improve patellar capture and a less constrained trochlear angle to reduce path errors of the patellar prosthesis&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">It was Merchant who&#44; in 2001&#44; designed a modular patellofemoral prosthesis based on the design of the LCS total knee prosthesis&#44; with some design inspiration from Richards&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> This was a patellar implant prosthesis with mobile and congruent anatomical polyethylene seated on a thin metal base&#46; Congruence improved any potential polyethylene wear problems&#44; whereas mobility decreased shear forces and thus reduced loosening&#46; This patellar component was articulated with a metallic trochlear component&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The percentages of reviews in LCS patellofemoral arthroplasties with mobile polyethylene have been high&#44; even leading some authors to abandon their use&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> The weakest point of the LCS patellofemoral prosthesis lies in the interface of the articulated polyethylene insert with the metallic base&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Dislocation of the polyethylene component is a rare complication&#46; So far&#44; we found 9 reported cases in the literature of polyethylene dislocations in LCS patellofemoral prostheses&#58; Witjes et al&#46; reported 2 cases in 2009&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Van Jonbergen et al&#46; reported 2 cases in 2009&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Sreekumar et al&#46; reported 1 case in 2009&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Arumilli et al&#46; reported 2 cases in 1 patient &#40;repetition&#41; in 2010<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> and Charalambous et al&#46; reported 2 cases in 2011&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">The causes of component dissociation would be multifactorial&#58; poor surgical technique regarding the placement of implants&#44; prosthetic design and selection of patients&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Leadbetter collects a personal communication by Fulkerson&#44; stating that high patella leads to a risk of collision in the first degrees of flexion of the patellar component at the top ridge of the femoral prosthesis&#44; with this posing a risk of dislocation&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> This would be a cause of residual clicking and locking sensation in the initial designs of Lubinus&#44; which Argenson et al&#46; attempted to compensate by inserting the femoral component slightly deeper&#44; with the drawback of creating a femoral notch&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Other authors have noted that dislocation occurs when the polyethylene rotates over 30&#176;&#44; at which point it jumps over the pin anchoring it to the metal base&#44; which stays in place&#46; In other words&#44; the problem would be a wrong position of the patellar insert&#44; leading to a rotation of the polyethylene over 30&#176; on the base&#46; In order to avoid this&#44; we must be careful when orienting the patella&#44; as this orientation takes place with the patella in an everted position&#44; and its transverse axis is not the same when everted as after being reduced&#46; With an everted patella&#44; the patellar guide should be placed with about 20&#176; inferior deflection&#46; Thus&#44; when its transverse axis is reduced&#44; it will be parallel to the transverse axis of the knee&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> But even after adequately orienting the patellar metal base&#44; patellofemoral malalignment or instability represent contraindications&#44; as they may require a rotation of the polyethylene over 35&#176;&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> A wrong patellar path could cause the corner of the polyethylene component to become caught in the margin or corner of the femoral trochlear component&#44; leading to polyethylene dislocation&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">One advantage introduced by the LCS design in patellofemoral arthroplasties is that&#44; in case conversion into total knee arthroplasty becomes necessary&#44; it is not necessary to replace the patella&#46; Obviously&#44; if a dislocation of the polyethylene from the patellar base takes place&#44; total replacement will be required in order to correct the deficiencies leading to this complication&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">In the case described it seemed that a previous high patella &#40;with an Insall&#8211;Salvati index of 1&#46;29&#41; was the reason that led to a high prosthetised patella with respect to the trochlear insert&#44; eventually leading to the polyethylene becoming caught on the trochlear edge and dislocating upon flexion&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The use of patellofemoral arthroplasties remains controversial&#46; Arumilli et al&#46; observed high rates of review after a short series of mobile patellofemoral arthroplasties&#44; leading them to abandon the technique&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Charalambous et al&#46; conducted an independent&#44; short-term review of mobile LCS patellofemoral prostheses with disappointing results&#46; They reported a high percentage of reviews and concluded that their use could not be recommended&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In any case&#44; patellofemoral prostheses do not replace patellofemoral realignment&#44; and in the event of there existing a patellofemoral misalignment and obviously also a high patella&#44; these should be corrected during the same surgical procedure of patellofemoral prosthesis&#44; adapting the technique to the previous pathology&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Level of evidence</span><p id="par0095" class="elsevierStylePara elsevierViewall">Level of evidence IV&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ethical responsibilities</span><p id="par0100" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Protection of people and animals</span>&#46; The authors declare that this investigation did not require experiments on humans or animals&#46;<span class="elsevierStyleVsp" style="height:0.5px"></span><span class="elsevierStyleBold">Confidentiality of data</span>&#46; The authors declare that this study does not reflect any patient data&#46;<span class="elsevierStyleVsp" style="height:0.5px"></span><span class="elsevierStyleBold">Right to privacy and informed consent</span>&#46; The authors declare that this study does not reflect any patient data&#46;</p></span></span>"
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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Patellofemoral arthroplasty is an infrequently used surgical technique because of its controversial results&#46; In an attempt to improve the results&#44; a design with a mobile-bearing polyethylene patellar component has been developed&#46; We describe a clinical case with an unusual complication&#58; the dislocation of polyethylene from the metal backing&#59; and accordingly&#44; we carried out a literature review of this complication&#46;</p>"
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        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La artroplastia femoro-patelar contin&#250;a siendo una t&#233;cnica quir&#250;rgica poco utilizada por los discutidos resultados obtenidos&#46; En un intento de mejorar sus resultados se introdujo el dise&#241;o con polietileno m&#243;vil&#46; Presentamos un caso cl&#237;nico con una complicaci&#243;n poco frecuente&#58; la luxaci&#243;n del polietileno de la base met&#225;lica de la patela&#59; y a prop&#243;sito realizamos una revisi&#243;n bibliogr&#225;fica de esta complicaci&#243;n&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara">Please cite this article as&#58; Sang&#252;esa Nebot MJ&#44; et al&#46; Luxaci&#243;n del polietileno en pr&#243;tesis patelo-femoral con patela m&#243;vil&#46; Caso cl&#237;nico&#46; Rev Esp Cir Ortop Traumatol&#46; 2012&#59;<span class="elsevierStyleBold">56</span>&#58;385&#8211;8&#46;</p>"
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            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radiographic patterns of osteoarthritis of the knee joint in the community&#58; the importance of the patellofemoral joint"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;O&#46; McAlindon"
                            1 => "S&#46; Snow"
                            2 => "C&#46; Cooper"
                            3 => "P&#46;A&#46; Dieppe"
                          ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "1992"
                        "volumen" => "51"
                        "paginaInicial" => "844"
                        "paginaFinal" => "849"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1632657"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The low contact stress patellofemoral replacement&#46; High early failure rate"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46;P&#46; Charalambous"
                            1 => "Z&#46; Abiddin"
                            2 => "S&#46;P&#46; Mills"
                            3 => "S&#46; Rogers"
                            4 => "P&#46; Sutton"
                            5 => "R&#46; Parkinson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Bone Joint Surg Br"
                        "fecha" => "2011"
                        "volumen" => "93 B"
                        "paginaInicial" => "484"
                        "paginaFinal" => "489"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dissociation of mobile-bearing patellar component in low contact stress patellofemoral arthroplasty&#46; Its mechanism and management&#58; two case reports"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
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                            2 => "A&#46;F&#46;W&#46; Barnaart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cases J"
                        "fecha" => "2009"
                        "volumen" => "2"
                        "paginaInicial" => "750"
                        "paginaFinal" => "752"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dislocation of the mobile bearing component of a patellofemoral arthroplasty&#58; a report of two cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Witjes"
                            1 => "C&#46; Van Den Broek"
                            2 => "S&#46; Koeter"
                            3 => "C&#46; Van Loon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Orthop Belg"
                        "fecha" => "2009"
                        "volumen" => "75"
                        "paginaInicial" => "411"
                        "paginaFinal" => "416"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19681331"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The appropriate use of patellofemoral arthroplasty&#46; An analysis of reported indications&#44; contraindications and failures"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "W&#46;B&#46; Leadbetter"
                            1 => "P&#46;S&#46; Ragland"
                            2 => "M&#46;A&#46; Mont"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Orthop"
                        "fecha" => "2005"
                        "volumen" => "436"
                        "paginaInicial" => "91"
                        "paginaFinal" => "99"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15995426"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patellar button dissociation in a mobile-bearing LCS patellofemoral joint arthroplasty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Sreekumar"
                            1 => "S&#46; Subramanian"
                            2 => "A&#46; Mohammed"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Knee Surg"
                        "fecha" => "2009"
                        "volumen" => "22"
                        "paginaInicial" => "275"
                        "paginaFinal" => "278"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19634736"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Indications&#44; contraindications&#44; and pitfalls of patellofemoral arthroplasty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "W&#46;B&#46; Leadbetter"
                            1 => "T&#46;M&#46; Seyler"
                            2 => "P&#46;S&#46; Ragland"
                            3 => "M&#46;A&#46; Mont"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Joint Surg"
                        "fecha" => "2006"
                        "volumen" => "88A"
                        "numero" => "Suppl&#46; 4"
                        "paginaInicial" => "122"
                        "paginaFinal" => "137"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early results with a total patellofemoral joint replacement arthroplasty prosthesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;C&#46; Merchant"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Arthroplasty"
                        "fecha" => "2004"
                        "volumen" => "19"
                        "paginaInicial" => "829"
                        "paginaFinal" => "836"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15483797"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
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Article information
ISSN: 19888856
Original language: English
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos