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Patella in Total Knee Replacement: Patellar Resurfacing has Better Outcomes than Lateral Facetectomy at One Year Follow-Up

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Patella in Total Knee Replacement: Patellar Resurfacing has Better Outcomes than Lateral Facetectomy at One Year Follow-Up

Tomas Alfredo Esteves, MD, ARGENTINA Matias Novillo, MD, ARGENTINA Tomas Nicolino, MD, ARGENTINA Matias Costa-Paz, MD, PhD, ARGENTINA Lisandro Carbó, MD, ARGENTINA Julian Costantini, MD, ARGENTINA

Hospital Italiano de Buenos Aires, Capital Federal , Buenos Aires, ARGENTINA

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Knee Patellofemoral

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Arthroplasty Total Joint Replacement

Summary: Ambispective cohort study. There is controversy regarding various aspects of what to do with the patellar component in total knee replacement (TKR). Lateral facetectomy and patellar resurfacing have been demonstrated to be superior to osteofitectomy and denervation of the patella. But there is poor information comparing these two alternatives of treatment.

Background

There is controversy regarding various aspects of what to do with the patellar component in total knee replacement (TKR). We found in the literature, disparity in the postoperative outcomes and complications associated with the different options. Lateral facetectomy and patellar resurfacing have been demonstrated to be superior to osteofitectomy and denervation of the patella. But there is poor information comparing these two alternatives of treatment.

Objectives
To compare pain and functional outcomes with Visual Analog Scale (VAS), 2011 2011 Knee Society Knee Scoring System (KSS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) in postoperative primary total knee replacement patients according to the treatment on the patellar component: replacement with patellar button (group 1) or lateral facetectomy (group 2). With preoperative evaluation and 12 months after surgery.

Design and Methods
Ambispective cohort study. We included 89 patients with knee osteoarthritis that were divided into two groups. 43 who underwent TKR with lateral facetectomy and 46 who were performed TKR with patellar resurfacing. In order to complete the sample size, we continued to prospectively include the necessary patients.
Demographic data, pre and postoperative mechanical axis of the lower limb, the prosthetic model used, pre and postoperative 2011 KSS, KOOS, and VAS were evaluated. Also, complications within the first 90 days of surgery were analyzed.
According to Zhang et al a mean postoperative KSS of 88.8 (SD 5+/-) for the facetectomy group and a mean of 83.4 (SD +/-7.6) for the non-facetectomy group were considered, with

Significance

level of 0.05 and a power of 80%, at least 24 patients per group would be needed. Considering a loss of 20% and the need to perform an analysis that takes into account confounders, at least 40 patients per group are estimated to be necessary.

Results

Significant differences were found for the patellar resurfacing group in the postoperative categories of overall KSS (p=0,002) and satisfaction KSS (p=0,046) and in the postoperative categories of KOOS symptoms (p=0,002) and quality of life (p=0.004) with better results for these patients. No significant differences in VAS. There were no complications associated with each procedure. Linear regression was performed with age, BMI, pre and postoperative mechanical axis of the lower limb and prosthetic models used, without a relationship with the results described above.

Conclusion

Our study suggests that patients with patellar resurfacing one year after surgery have better outcomes in the variables overall KSS and satisfaction KSS and in the variables symptoms KOOS and quality of life KOOS.

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Intra- And Inter-Operator Reliability Assessment Of A Novel Extramedullary Accelerometer-Based Smart Cutting-Guide For Total Knee Arthroplasty: An In-Vivo Study ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Domenico Alesi, MD, ITALY Arcangelo Russo, MD, ITALY Mirco Lo Presti, MD, ITALY Iacopo Sassoli, MD, ITALY Matteo La Verde, MD, ITALY Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY
Total Knee Arthroplasty Without Patellar Component Replacement. Does it Increase the Risk of Revision? Local Experience Analysis ePoster Presentation Zoy Anastasiadis, MD, CHILE Diego Edwards, MD, CHILE Sergio Arellano, MD, CHILE Andrés Schmidt-Hebbel, MD, CHILE Eduardo Gardella, MD, CHILE Nicolás González-Kusjanovic, MD, MSc, CHILE Alex Vaisman, MD, Prof., CHILE
Influence of Mini Approach Instrumentation on Component Alignment In Unicondylar Knee Replacement ePoster Presentation Vinod Kumar, MBBS, MS, DNB, MNAMS, INDIA Deepak Gupta, MBBS, MS, INDIA Ananya Sharma, MBBS, MS, DNB , INDIA
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY
Comparison of Outcomes between Fungal and Non-fungal Periprosthetic Joint Infections in Total Knee Arthroplasty: A Propensity Score-Matched Analysis ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Implant Size and Outcome Differences of Knees in Same Patient for Simultaneous vs Staged Bilateral TKA ePoster Presentation Alexander P. Sah, MD, UNITED STATES
Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study ePoster Presentation Daniel E Matthews, MD, FAAOS, UNITED STATES
Time-Driven Activity-Based Costs for Manipulation Under Anesthesia after Total Knee Arthroplasty ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Suzanne Kent, MD, UNITED STATES John Mazzocco, MD, UNITED STATES Lauren Schoeller, BS, UNITED STATES Ruijia Niu, MPH, UNITED STATES Daniel C Sun, UNITED STATES Eric L. Smith, MD, UNITED STATES
The Statistical Fragility of Tourniquet Use In Total Knee Arthroplasty: A Systematic Review ePoster Presentation Kyle William Lawrence, BS, UNITED STATES John K Cordero, MD, UNITED STATES Ashley Brown, BS, UNITED STATES Xinning Li, MD, UNITED STATES Brett Hayden, MD, UNITED STATES Robert L Parisien, MD, UNITED STATES
Effect of Altered Knee Joint Loading Pattern in Gait Biomechanics of Total Knee Arthroplasty Patient ePoster Presentation Sang Jin Lee, MD, PhD, KOREA, REPUBLIC OF
Use of Tibial Stem for Patients with Morbid Obesity in Total Knee Arthroplasty ePoster Presentation José Eduardo Flores Naranjo, MD, MEXICO Adrian Aziz Cortes De La Fuente, MD, MEXICO Octavio Martinez Montiel, MD, MEXICO Fernando Martinez Zuñiga, MD, MEXICO
Intraoperative Surgeon-Performed vs. Conventional Anesthesiologist-Performed Continuous Adductor Canal Block In Total Knee Arthroplasty: A Randomized Controlled Trial ePoster Presentation Chayut Chaiperm, MD, THAILAND Srihatach Ngarmukos, MD, THAILAND Aree Tanavalee, MD, THAILAND Chotetawan Tanavalee, MD, THAILAND Wirinaree Kampitak, MD, THAILAND
Is Surgeon Assessed Bone Quality During Total Knee Arthroplasty a Valid Tool To Diagnose Osteoporosis ? ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Arpit Vasantbhai Bavaskar, MBBS, D.Orth., INDIA Vishal Raina, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Ashwini Khokhar, MS, INDIA Rajesh Maniar, INDIA
Efficacy of Functional Alignment Technique In Robotic-Arm Assisted Total Knee Arthroplasty ePoster Presentation Masashi Tamaki, MD, PhD, JAPAN Yuki Yamauchi, MD,PhD, JAPAN Seishiro Higa, MD, JAPAN Tomoyuki Shimakawa, MD, JAPAN Yuki Isobe, MD, JAPAN Teruya Ishibashi, MD,PhD, JAPAN Shoji Konda, PhD, JAPAN Tetsuya Tomita, M.D.,Ph.D , JAPAN
High Cure Rate In Hematogenous TKA PJI At A Long-Term Follow-Up By Means Of Dair Procedure ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN Pedro Hinarejos, MD, PhD, SPAIN

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Patella in Total Knee Replacement: Patellar Resurfacing has Better Outcomes than Lateral Facetectomy at One Year Follow-Up

Patella in Total Knee Replacement: Patellar Resurfacing has Better Outcomes than Lateral Facetectomy at One Year Follow-Up

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Patella in Total Knee Replacement: Patellar Resurfacing has Better Outcomes than Lateral Facetectomy at One Year Follow-Up

Patella in Total Knee Replacement: Patellar Resurfacing has Better Outcomes than Lateral Facetectomy at One Year Follow-Up

Background

Significance

Results

Conclusion

More 2023 ISAKOS Congress Content