Blackburne–Peel ratio predicts patients’ outcomes after total knee arthroplasty

Behrend, Henrik; Graulich, Tilman; Gerlach, Rene; Spross, Christian; Ladurner, Andreas

doi:10.1007/s00167-018-5016-1

Cited by 30 publications

(23 citation statements)

References 29 publications

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“…Patella baja (PB) is a real shortening of the patellar tendon, and pseudo-patella baja (PPB) is a relative shortening of the patellar tendon by elevation of the tibial plateau. PB and PPB are known to affect patellofemoral joint movement; a shortening of more than 10% of the patellar tendon is assumed to significantly reduce knee flexion due to the reduced length of the extensor apparatus (1)(2)(3). The consequences of PB and PPB are muscular imbalance and mechanical retropatellar overload, both of which can cause patellofemoral pain syndrome (3,4).…”

mentioning

confidence: 99%

“…PB and PPB can be defined by measuring the Insall-Salvati index (ISI), the modified Insall-Salvati index (mISI), the Caton-Dechamps index (CDI), and the Blackburne-Peel index (BPI) on lateral knee x-rays in 45˚ knee flexion (3,8,9). The postoperative incidence of PB ranges from 0.7% to 37%, depending on the operative method (2,5,10,11). PPB can be found in 25% to 47% of patients after primary TKA (2,12).…”

mentioning

confidence: 99%

“…The postoperative incidence of PB ranges from 0.7% to 37%, depending on the operative method (2,5,10,11). PPB can be found in 25% to 47% of patients after primary TKA (2,12). Behrend et al have shown that PPB predicts impaired postoperative outcome with reduced range of motion after primary TKA.…”

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confidence: 99%

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Reduction of Patella-baja and Pseudo-patella-baja Does Not Improve Range of Motion in Patients After Mega-TKA

Graulich

Kranz

Zhang

et al. 2020

In Vivo

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Background/Aim: Patella baja (PB) and pseudopatella baja (PPB) have been shown to negatively influence outcomes after total knee arthroplasty. We hypothesized that there is a high incidence of PB and PPB after megaprosthetic total knee arthroplasty (M-TKA), and that this is associated with reduced range of motion. Patients and Methods: We retrospectively analysed all patients in our Orthopaedic Trauma Department after distal femur or proximal tibia replacement. Preoperative and one-year postoperative followup included measurement of range of motion and detection of PB and PPB using radiological indices. Results: We included 44 patients (age: 73±19 years). Preoperative PB detected by ISI could be reduced from 13 (36%) to 11 (25%) (p<0.01). Preoperative vs. postoperative ISI was 0.88±0.23 vs. 1.06±0.45 (p=0.03). PPB was observed preoperatively in 23 (63%) patients vs. 24 (54%) postoperatively. Preoperative vs. postoperative CDI was 0.70±0.24 vs. 0.95±0.43 (p=0.002). Preoperative flexion was 91˚±30˚ vs. 85˚±24˚ postoperatively (p>0.05). Conclusion: Both PB and PPB are frequently observed after M-TKA. A reduction in PB and PPB alone does not improve postoperative range of motion.

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Reduction of Patella-baja and Pseudo-patella-baja Does Not Improve Range of Motion in Patients After Mega-TKA

Graulich

Kranz

Zhang

et al. 2020

In Vivo

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“…Elevated joint line, whether due to inadequate resection of tibia, excessive resection of distal femur, or thick polyethylene inserts, leads to patella baja. Patella baja has been associated with decreased postoperative ROM and patient reported outcome measures [24,25]. The importance of maintaining correct patellar height is further demonstrated by Vives-Barquiel et al by showing improvements in flexion and clinical scores after osteotomy of the tibial tuberosity to move it proximally in knees with postoperative patella baja [26].…”

Section: Intraoperative Risk Factorsmentioning

confidence: 99%

Stiffness after Primary Total Knee Arthroplasty

Singh¹,

Berdis²,

Goel³

et al. 2020

Knee Surgery - Reconstruction and Replacement

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Total knee arthroplasty remains the definitive treatment for end-stage osteoarthritis of the knee. Despite being a very successful intervention in terms of relieving pain and returning a patient's function, it is not without complications. Post-operative stiffness after total knee arthroplasty is one of those complications that can be puzzling for physicians and debilitating for patients. While the etiology of stiffness is multifactorial, the treatment options are essentially limited to manipulation under anesthesia, removal of adhesions and revision total knee arthroplasty. With patient outcomes directly related to relief of pain and post-operative range of motion, it is paramount that surgeons do all that is necessary to minimize risk of post-operative stiffness.

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“…Затем оценивали последние стандартные рентгенограммы в прямой и боковой проекциях в сравнении с архивом пред-и послеоперационных рентгенограмм. Определяли стабильность фиксации компонентов, наличие признаков остеолизиса, адекватность размера и пространственного расположения установленных компонентов, оценивали высоту положения надколенника [12][13][14]. Далее проводился тщательный анализ КТсканирования, оценка положения компонентов в аксиальной плоскости по технике, описанной R.a. Berger с соавторами [15,16].…”

Section: материал и методыunclassified

Evaluation of Pain Syndrome in Patients after Total Knee Replacement

Мурылев

Алексеев

Елизаров

et al. 2019

Traumatology and Orthopedics of Russia

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Total joint replacement is one the most effective methods for treatment of degenerative, systemic and posttraumatic diseases of the knee. However, up to 25% of patients remain dissatisfied with surgery outcomes. In the majority of cases the patients complain of pain in the operated joint. Identification of pain cause in the operated joint can turn to become a challenge for the surgeon.Purpose of the study — to identify the causes of pain syndrome basing on examination algorithm in patients after TKR as well as to assess the diagnostic value of each particular examination method.Materials and Methods. The authors analyzed results of comprehensive examination of 79 patients who complained of chronic knee pain after primary TKR and seeked medical help from the beginning of 2016 until December 2018. Inclusion criteria were as follows: knee prosthesis and presence of pain syndrome in the operated joint. Exclusion criteria: fistulous peri-prosthetic infection, suspected “culture-negative” infection and revisions. All patients included into the study were managed according to the standard algorithm of comprehensive examination.Results. The most likely causes of pain were identified during the examination. Infection was observed in 39 patients (49.4%), errors in three-dimensional positioning of components was considered as a probable cause of pain in 14 patients (17.7%), aseptic loosening was reported in 13 cases (16.5%), ligamentous instability — in 6 patients (7.6%), extraarticular pain origin was observed in 5 patients (6.3%) and peri-prosthetic fractures were reported in two patients (2.5%). The authors confirmed a combination of several pain causes in 17 patients (21.5%).Conclusion. Examination of patients with painfull knee joint prosthesis should be comprehensive due to potential combination of issues in each particular case. Integral and systematic approach to pain diagnostics in the operated joint is the “key to success” for planning further treatment tactics and for understanding the necessity and scope of revision procedure.

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Blackburne–Peel ratio predicts patients’ outcomes after total knee arthroplasty

Abstract: Level 3.

Cited by 30 publications

References 29 publications

Reduction of Patella-baja and Pseudo-patella-baja Does Not Improve Range of Motion in Patients After Mega-TKA

Reduction of Patella-baja and Pseudo-patella-baja Does Not Improve Range of Motion in Patients After Mega-TKA

Stiffness after Primary Total Knee Arthroplasty

Evaluation of Pain Syndrome in Patients after Total Knee Replacement

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