Resurfacing in a Posterior-Stabilized Total Knee Arthroplasty Reduces Patellar Crepitus Complication: A Randomized, Controlled Trial
| Autor: | Bhakawat Chiamtrakool, Satit Thiengwittayaporn, Kakanand Srungboonmee |
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| Rok vydání: | 2019 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Knee Joint medicine.medical_treatment Radiography Total knee arthroplasty Pain Prosthesis law.invention Patellofemoral Joint 03 medical and health sciences Postoperative Complications 0302 clinical medicine Randomized controlled trial law medicine Humans Knee Orthopedics and Sports Medicine Femur Postoperative Period Prospective Studies Arthroplasty Replacement Knee Aged Pain Measurement 030222 orthopedics Crepitus business.industry Incidence Incidence (epidemiology) Posterior stabilized Patella Middle Aged Osteoarthritis Knee musculoskeletal system Biomechanical Phenomena Surgery Treatment Outcome Female medicine.symptom Knee Prosthesis Complication business |
| Zdroj: | The Journal of Arthroplasty. 34:1969-1974 |
| ISSN: | 0883-5403 |
| DOI: | 10.1016/j.arth.2019.04.050 |
| Popis: | Background Patellar crepitus (PC) is a common complication after total knee arthroplasty (TKA) using a posterior-stabilized (PS) prosthesis. While numerous factors have been associated with PC development after PS-TKA, patellar resurfacing (PR) which directly impacts the patellofemoral joint kinematics has been underinvestigated. A prospective, randomized, controlled trial was conducted to (1) compare the PC incidence in PR and non-PR PS-TKA, (2) determine the time of PC presentation in PS-TKA, (3) identify radiographic parameters associated with PC, and (4) compare clinical outcomes of patients with and without PR. Methods A total of 84 patients who underwent unilateral TKA using the Legion PS Total Knee System were randomized into PR group or non-PR group. PC incidence, time of PC presentation, radiographic parameters associated with PC development, and clinical outcomes were evaluated at 3 months, 6 months, 9 months, and 1 year postoperatively. Results PC occurred significantly more in the non-PR group (23.1% vs 7.3%, P = .048). Time of PC presentation in both groups was not different. Anterior knee pain was found in 16.7% of crepitus patients, and none required any surgical procedure. The non-PR knees had significant decreases in patellar shift index, patellar displacement, Insall-Salvati ratio, and patellar component height and increase in change in posterior femoral offset. Oxford and patellar scores were significantly better in the PR group at 9 months and 1 year. Conclusion Given higher PC incidence and several worse clinical outcomes in the non-PR, we recommend resurfacing during PS-TKA with this knee system to avoid PC development. |
| Databáze: | OpenAIRE |
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