Does total contact of the patella with the femoral trochlea during no thumb test significantly reduce anterior knee pain?
| Autor: | Hiren Patel, Jitesh Manghwani, Shrinand V Vaidya, Chintan S Vaidya |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
musculoskeletal diseases
Male Knee Joint Visual Analog Scale Visual analogue scale medicine.medical_treatment Thumb 03 medical and health sciences 0302 clinical medicine Prosthesis Fitting Medicine Humans Orthopedics and Sports Medicine Prospective Studies Prospective cohort study Arthroplasty Replacement Knee Reduction (orthopedic surgery) Aged Orthodontics Aged 80 and over 030222 orthopedics Pain Postoperative Lateral retinaculum Crepitus business.industry 030229 sport sciences Patella Middle Aged musculoskeletal system medicine.anatomical_structure Female Implant medicine.symptom business Knee Prosthesis |
| Zdroj: | The Knee. 26(6) |
| ISSN: | 1873-5800 |
| Popis: | Background Complications such as anterior knee pain (AKP) and crepitus continue to be causes of dissatisfaction after total knee arthroplasty (TKA). This prospective study aimed to study the significance of total patellar contact with the femoral trochlea of the implant, with the no thumb test during trial reduction, and its effect on reducing AKP. Methods Between 2014 and 2016, 445 patellofemoral joints (M:F 126:319, age 45–80 years) and their contact with the trochlea of the femoral component were graded at trial reduction without lateral retinaculum release (Grades I, Ia, II, III based on existing publications). The aim was to restore all patellae to pre-operative thickness. Posterior stabilized implants with a domed patella were used in all cases. The Knee Society Score (KSS) and Visual Analogue Scale (VAS) score were noted at follow up between 12 and 24 months after surgery. Results AKP was significantly lower with 100% patellofemoral contact. The KSS and VAS had statistically significant P-values of 0.021 and 0.025 in Grade I and Ia contact, respectively. Better results were achieved where patellar thickness was restored in Grades I and Ia with P-values of 0.041 and 0.046 for VAS change and 0.038 and 0.044 for KSS change, respectively. Conclusion At follow up, superior results were obtained where there was a complete patellofemoral contact at trial reduction in Grade I and Grade Ia, and when other confounding factors such as patellar thickness and normal rotation of the femoral and tibial components were standardized. To minimize AKP it is imperative to have total patellar contact with the femoral trochlea. |
| Databáze: | OpenAIRE |
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