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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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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
Modular Knee Arthrodesis as Definitive Treatment for Periprosthetic Infection, Bone Loss, and Failure of the Extensor Mechanism after Total Knee Arthroplasty ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Maksym Bartashevskyy, BA, UNITED STATES Zachary Berliner, MD, UNITED STATES Ruijia Niu, MPH, UNITED STATES James V. Bono, MD, UNITED STATES Ayesha Abdeen, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES
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
Unicompartmental Knee Replacement and Femoropatellar Arthritis. 110 Ahroplasties with a Mean Follow p of 6 years. ePoster Presentation Stefano Gaggiotti, MD, ARGENTINA Santino Gaggiotti, MD, ARGENTINA Julio Cesar Ringa Gabriel Gaggiotti, MD, ARGENTINA
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY
Factors Associated With Failure and Survivorship Following Unicompartmental Knee Arthroplasty: A Single-Center Experience ePoster Presentation Anirudh K Gowd, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES Asher Lichtig, MD, UNITED STATES Orhan Yanmis, MD, UNITED STATES Gary G. Poehling, MD, UNITED STATES
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
Treatment of Periprosthetic Infection after Total Knee Arthroplasty using an Ultrastatic Spacer ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Suzanne Kent, MD, UNITED STATES Ruijia Niu, MPH, UNITED STATES Ayesha Abdeen, MD, UNITED STATES Eric L. Smith, MD, 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
In-Vivo Kinematic Analysis of Evolution® Medial-Pivot Total Knee Arthroplasty during Weight-Bearing Activity ePoster Presentation Eiichi Nakamura, MD, PhD, JAPAN Nobukazu Okamoto, MD, PhD, JAPAN Hitoshi Ito, MD, PhD, JAPAN Tetsurou Masuda, MD, PhD, JAPAN Satoshi Hisanaga, MD, PhD, JAPAN Yasunari Oniki, MD, PhD, JAPAN
Changes In CPAK Classification and Its Characteristics before and after Kinematic Alignment TKA ePoster Presentation Manabu Akagawa, MD, PhD, JAPAN ヒデトモサイトウ, MD, PhD, JAPAN Naohisa Miyakoshi, MD, PhD, JAPAN
Relationship Between The Femoral And Tibial Component Positions And Postoperative Knee Range Of Motion After Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Long-Term Results of Per-Operative Knee Arthroscopy in Confirming Suitability for Unicompartmental Arthroplasty ePoster Presentation James Gill, MB BChir, BSc, FRCS, UNITED KINGDOM McMeniman J Peter, AUSTRALIA Timothy John Mcmeniman, MBBS(Med)/MBBS, FRACS FA(Orth)A, AUSTRALIA Daniel Johnson Brimm, BSc, MD, AUSTRALIA Peter T. Myers, AM, MBBS, FRACS, FAOrthA, AUSTRALIA

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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