Patellar height after unicompartmental knee arthroplasty: comparison between fixed and mobile bearing.

Autor: D'Ambrosi R; IRCCS Istituto Ortopedico Galeazzi, Via Galeazzi 4, 20161, Milan, Italy. riccardo.dambrosi@hotmail.it., Buda M; Ospedale Monselice 'Madre Teresa di Calcutta', Monselice, Padua, Italy., Nuara A; Università degli Studi di Milano, Milan, Italy., Mariani I; Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', Trieste, Italy., Scelsi M; IRCCS Istituto Ortopedico Galeazzi, Via Galeazzi 4, 20161, Milan, Italy., Valli F; IRCCS Istituto Ortopedico Galeazzi, Via Galeazzi 4, 20161, Milan, Italy., Ursino N; IRCCS Istituto Ortopedico Galeazzi, Via Galeazzi 4, 20161, Milan, Italy., Hirschmann MT; Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland, Bruderholz, Switzerland.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2022 Nov; Vol. 142 (11), pp. 3449-3460. Date of Electronic Publication: 2021 Oct 20.
DOI: 10.1007/s00402-021-04183-6
Abstrakt: Purpose: The purpose of this study was to determine the changes in patellar heights by comparing standardised pre- and post-operative radiographs in a consecutive series of patients undergoing unicompartmental knee arthroplasty (UKA) with two different approaches and implant designs [fixed bearing (FB) vs mobile bearing (MB)] and to correlate the patellar heights with clinical outcomes.
Methods: One hundred and seventy-two UKA patients were prospectively enrolled in the study. 75 patients underwent a minimally invasive FB medial UKA (referred to hereinafter as the 'FB group'); 97 patients were treated with a minimally invasive MB medial UKA. The pre-operative and mid-term (1-year) post-operative patellar heights and clinical scores of these groups of patients were compared using the Insall-Salvati (IS) and Caton-Deschamps (CD) indices and the Oxford Knee Score (OKS).
Results: No differences were found between the two groups either with regard to the pre-operative data (p > 0.05) or between pre- and post-operative radiographic scores at the time of each follow-up (p > 0.05). Both the groups reported a significant clinical improvement (p<0.05) as did all the sub-groups (p < 0.05). In the MB group, a higher CD index in females was found at the final follow-up stage (p = 0.043) and a higher pre-operative CD index was found in patients with BMI ≥ 28 (p = 0.040). A statistically negative correlation was found between the pre-operative OKS and pre-operative IS index (rho=- 0.165; p=0.031).
Conclusions: Both FB and MB arthroplastys with different surgical approaches did not change the patellar height regardless of the age, gender and BMI at short-medium-term follow-up. The post-operative patellar height seems not to be correlated with the clinical outcomes. A higher pre-operative IS index was correlated with knee pain and function.
Level of Evidence: Level II-prospective comparative study.
Study Registration: Researchregistry6433- www.researchregistry.com .
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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