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Bilateral simultaneous total knee arthroplasty with and without patellar resurfacing. A prospective single surgeon series with a minimum follow‑up of 7 years

Leonel Perez Alamino|German Garabano|Cesar Ángel Pesciallo|Hernán Del Sel
대한슬관절학회 (Korean Knee Society)|2024.12|Knee Surgery and Related Research|제36권 |pp. 21-21|DOI 10.1186/s43019-024-00225-6

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Knee osteoarthritisTotal knee arthroplastyJoint replacementPatellar resurfacing

초록

Background: Total knee arthroplasty (TKA) is the most effective treatment for end-stage adult knee osteoarthritis, but it has been reported that patient satisfaction may vary. A malfunction of the patellofemoral joint may produce anterior knee pain (AKP) for several reasons. While some surgeons systematically resurface the patella despite the risk of potential complications such as fracture, loosening, or wear of the patella, others prefer to preserve it to reduce AKP and revision rates. This study aimed to evaluate whether patellar resurfacing had better clinical and functional outcomes, complications, and revision rates in patients undergoing simultaneous bilateral total knee arthroplasty. Methods: We conducted a prospective cohort study, including patients who underwent bilateral simultaneous TKA in which the patella was replaced in one knee and preserved in the other, with a minimum follow-up of 7 years. We assessed clinical and functional outcomes with the Knee Society Score (KSS) and Visual Analogue Scale (VAS); complications and revision rates were also registered. Results: The final series consisted of 43 patients with 86 knee arthroplasties. After a mean of 7.6 years of follow-up, no significant differences were found regarding KSS (clinical: 82.8 ± 7.4 versus 83.2 ± 3.4, p=0.92; 89.1 ± 8.2: versus 90.4 ± 6.8; p=0.99), VAS (2.0 ± 0.9 versus 1.8 ± 1.0; p=0.84), complications (10.5% versus 8.1% ; p=57), or revision rates (2.3% versus 2.3% ; p=0.99) when comparing patellar resurfacing versus retention. Conclusion: In the context of total knee arthroplasty, patellar replacement did not demonstrate statistically significant differences concerning patellar retention in clinical nor functional outcomes, AKP, complications, or revision rates after a minimum of 7 years of follow-up.

Abstract

Background: Total knee arthroplasty (TKA) is the most effective treatment for end-stage adult knee osteoarthritis, but it has been reported that patient satisfaction may vary. A malfunction of the patellofemoral joint may produce anterior knee pain (AKP) for several reasons. While some surgeons systematically resurface the patella despite the risk of potential complications such as fracture, loosening, or wear of the patella, others prefer to preserve it to reduce AKP and revision rates. This study aimed to evaluate whether patellar resurfacing had better clinical and functional outcomes, complications, and revision rates in patients undergoing simultaneous bilateral total knee arthroplasty. Methods: We conducted a prospective cohort study, including patients who underwent bilateral simultaneous TKA in which the patella was replaced in one knee and preserved in the other, with a minimum follow-up of 7 years. We assessed clinical and functional outcomes with the Knee Society Score (KSS) and Visual Analogue Scale (VAS); complications and revision rates were also registered. Results: The final series consisted of 43 patients with 86 knee arthroplasties. After a mean of 7.6 years of follow-up, no significant differences were found regarding KSS (clinical: 82.8 ± 7.4 versus 83.2 ± 3.4, p=0.92; 89.1 ± 8.2: versus 90.4 ± 6.8; p=0.99), VAS (2.0 ± 0.9 versus 1.8 ± 1.0; p=0.84), complications (10.5% versus 8.1% ; p=57), or revision rates (2.3% versus 2.3% ; p=0.99) when comparing patellar resurfacing versus retention. Conclusion: In the context of total knee arthroplasty, patellar replacement did not demonstrate statistically significant differences concerning patellar retention in clinical nor functional outcomes, AKP, complications, or revision rates after a minimum of 7 years of follow-up.

참고문헌 (37)

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