Influence of femoral implant design modification on anterior knee pain and patellar crepitus in patients who underwent total knee arthroplasty without patella resurfacing

Abstract

Background : The incidence of patient dissatisfaction due to multiple factors, especially anterior knee pain (AKP) and patellar crepitus after total knee arthroplasty (TKA), remain a concern. Improvements in the femoral component of the traditional prosthesis could reduce the incidence of these complications in TKA performed with patellar resurfacing. This study aimed to explore whether TKA without patellar resurfacing benefits from this modification in femoral implant design with regard to AKP and patellar crepitus. Methods : Sixty-two patients (85 knees) who underwent TKA with the modern prosthesis and 62 age- and sex-matched patients (90 knees) fitted with the traditional prosthesis were enrolled in this study. The incidence of AKP and patellar crepitus, and Knee Society Score (KSS) was recorded. Statistical analyses were performed to determine whether there were differences between the groups. Results: The incidence of AKP was significantly lower in the study group compared with the control group at the 3-month and 1-year follow-ups (4.7% vs. 13.3% [ p =0.048] and 3.5% vs. 13.3% [ p =0.021], respectively). The incidence of patellar crepitus was significantly lower in the study group compared with the control group at the 3-month and 1-year follow-ups (15.3% vs. 34.4% [ p =0.004] and 10.6% vs. 28.9% [ p =0.002], respectively). There was no significant difference in KSS between the groups. Conclusion : Results revealed that TKA without patellar resurfacing benefited from the femoral implant design modification with regard to AKP and patellar crepitus. These data may be meaningful to surgeons who use the modern prosthesis and omit resurfacing the patella in their patients. Keywords : total knee arthroplasty, femoral component, prosthesis design, anterior knee pain, patellar crepitus

The Role of Stability and Alignment in Improving Patient Outcomes After Total Knee Arthroplasty

“…Even though TKA is one of the most effective operations in orthopaedic surgery, 20% to 30% of patients who have TKA experience residual symptoms after surgery 3-5 . A variety of factors have been implicated in this dissatisfaction rate: (1) patient-specific factors such as preoperative expectations; (2) perioperative factors such as postoperative pain control; (3) medical factors such as a history of substance abuse, Parkinson disease, and/or diabetes mellitus; and (4) technical factors such as alignment and stability of the knee 6-8 .…”

“…(2) perioperative factors such as postoperative pain control; (3) medical factors such as a history of substance abuse, Parkinson disease, and/or diabetes mellitus; and (4) technical factors such as alignment and stability of the knee [6][7][8] .…”