Lateral Patellar Facetectomy Reduces the Incidence of Anterior Knee Pain in Patellar Resurfaced Total Knee Arthroplasty

Abstract

Lateral patellar facet impingement (LPFI) can cause anterior knee pain (AKP) after patellar resurfaced total knee arthroplasty (TKA). Recently, lateral patellar facetectomy (LPF), which has been used for LPFI, has been performed during primary TKA, providing good clinical outcomes. However, the effect of LPF on AKP in primary patellar resurfaced TKA has not been sufficiently studied. The purpose of this study was to examine the effect of LPF on the development of AKP in patellar resurfaced TKAs with minimum follow-up of 3 years. This retrospective cohort study included 84 knees of 66 consecutive patients who underwent patellar resurfaced TKA between April 2007 and November 2014 in our hospital. The subjects were divided into two groups: TKA with LPF (LPF group; 47 knees) and TKA without LPF (no-LPF group; 37 knees). Postoperative AKP, the primary outcome, the Japanese Orthopaedic Association (JOA) score, and range of motion were investigated at the final visit and compared between the two groups. Six knees (16.2%) had AKP in the no-LPF group, whereas none of the knees had AKP in the LPF group at the final visit. The incidence of AKP was significantly lower in the LPF group (p = 0.004). The postoperative JOA score and flexion angle were significantly higher in the LPF group than in the no-LPF group. LPF correlated with less incidence of postoperative AKP and improved the JOA score and knee flexion angle. In patellar resurfaced TKA, LPF may be considered an additional maneuver to avoid postoperative AKP.

Anterior Knee Pain After Total Knee Arthroplasty

“…Such findings bring to light the multifactorial nature of this problem that would unlikely be resolved through a single-factor approach. However, when electing to resurface the patella, there is relatively strong evidence to recommend lateral patellar facetectomy to avoid impingement of the uncovered lateral facet that has been correlated with AKP 24 .…”

Pressurized carbon dioxide lavage reduces the incidence of a radiolucent line around the tibial component two years after total knee arthroplasty

“…The patellar component was medialized on the patellar resected surface, and the component with the largest diameter covering the whole medial aspect of the patella was selected. After placing the trial implant on the patella, lateral patellar facetectomy was performed by bone saw for the lateral aspect of the patella that was not covered by the implant [12]. All components were fixed with bone cement.…”