Patellar Resurfacing Versus No Resurfacing in Scorpio Total Knee Arthroplasty

Garneti, N.; Mahadeva, Dhirendra; Khalil, Aly; McLaren, Clare A.

doi:10.1055/s-0030-1247802

Cited by 19 publications

(23 citation statements)

References 10 publications

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“…Anterior knee pain was the most common complication in the non-resurfaced groups. These results have been supported by other literature suggesting resurfacing of the patella leads to lower rates of revision (Forster 2004, Pakos et al 2005, O'Shea et al 2006, Garneti et al 2008) or increased patient satisfaction (Schroeder-Boersch et al 1998, Mayman et al 2003, Waters and Bentley 2003, Burnett et al 2004, Gildone et al 2005, Parvizi et al 2005, Berti et al 2006, van Hemert et al 2009). Despite promising results, other studies have suggested that resurfacing of the patella does not change rates of revision, patient satisfaction, or clinical outcome (Grace and Sim 1988, Healy et al 1995, Robertsson et al 2000, Wood et al 2002, 2005, Burnett et al 2004, 2007, Campbell et al 2006, Myles et al 2006, Oztürk et al 2006, Smith et al 2006, 2008, Epinette and Manley 2008).…”

Section: Introductionsupporting

confidence: 76%

“…In the recent literature, it has been proposed that revision rates are lower in patients who have received patella resurfacing in total knee arthroplasty (Lindstrand et al 2001, Forster 2004, Pakos et al 2005, O'Shea et al 2006, Garneti et al 2008). This was confirmed in our study, as we found that the R group had a lower revision rate than the NR group, with a hazards ratio of 0.75 (p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

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Early outcomes of patella resurfacing in total knee arthroplasty

Clements¹,

Miller²,

Whitehouse³

et al. 2009

Acta Orthopaedica

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BackgroundPatella resurfacing in total knee arthroplasty is a contentious issue. The literature suggests that resurfacing of the patella is based on surgeon preference, and little is known about the role and timing of resurfacing and how this affects outcomes.MethodsWe analyzed 134,799 total knee arthroplasties using data from the Australian Orthopaedic Association National Joint Replacement Registry. Hazards ratios (HRs) were used to compare rates of early revision between patella resurfacing at the primary procedure (the resurfacing group, R) and primary arthroplasty without resurfacing (no-resurfacing group, NR). We also analyzed the outcomes of NR that were revised for isolated patella addition.ResultsAt 5 years, the R group showed a lower revision rate than the NR group: cumulative per cent revision (CPR) 3.1% and 4.0%, respectively (HR = 0.75, p < 0.001). Revisions for patellofemoral pain were more common in the NR group (17%) than in the R group (1%), and “patella only” revisions were more common in the NR group (29%) than in the R group (6%). Non-resurfaced knees revised for isolated patella addition had a higher revision rate than patella resurfacing at the primary procedure, with a 4-year CPR of 15% and 2.8%, respectively (HR = 4.1, p < 0.001).InterpretationRates of early revision of primary total knees were higher when the patella was not resurfaced, and suggest that surgeons may be inclined to resurface later if there is patellofemoral pain. However, 15% of non-resurfaced knees revised for patella addition are re-revised by 4 years. Our results suggest an early beneficial outcome for patella resurfacing at primary arthroplasty based on revision rates up to 5 years.

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Section: Introductionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Early outcomes of patella resurfacing in total knee arthroplasty

Clements¹,

Miller²,

Whitehouse³

et al. 2009

Acta Orthopaedica

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“…Although Epinette and Manley [7] failed to observe clinical differences in Scorpio 1 comparing resurfaced and nonresurfaced patellas, our results showing a clear muscular extensor advantage (as seen in the flexion/ extension ratio) lead us to caution about not resurfacing the patella in this design, following Garneti et al [11] who observed more anterior knee pain in nonresurfaced patellas with the Scorpio 1 design and suggested a more consistent outcome is achieved with patellar resurfacing.…”

Section: Discussionsupporting

confidence: 50%

Functional Performance with a Single-radius Femoral Design Total Knee Arthroplasty

Gómez‐Barrena

Fernandez-García

Fernández-Bravo

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Better muscular recovery of the extensor mechanism after TKA is claimed by femoral designs based on a sagittal single radius. Questions/purposes We aimed to compare postoperative knee performance through the Knee Society scores, flexor and extensor muscle function, stability, and gait of a series of patients receiving a posterior stabilized, cemented TKA, with a single-radius femoral design. Methods We compared a series of patients treated with a single-radius femoral design TKA to a simultaneous series of patients receiving a multiradius femoral design. Both groups were similar in demographics and preoperative Knee Society scores. The clinical pathways were identical. Outcome assessment included Knee Society scores, isokinetic assessment, stabilometry, and gait cycle analysis. ResultsWe observed higher functional Knee Society scores (86.6 ± 1.89 versus 80.3 ± 1.90), fewer physiotherapy sessions (19.9 ± 4.65 versus 22.2 ± 3.34), and less time with two crutches (3.5 ± 1.2 versus 5.2 ± 1.04 weeks) for patients receiving the single-radius design. Isokinetic evaluation showed decreased flexion peak torque (40.3 ± 7.9 versus 48.7 ± 9.6), increased extension peak torque (77.2 ± 16.1 versus 69.1 ± 14.4), and lower flexor/ extensor ratio (0.5 ± 0.08 versus 0.7 ± 0

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“…These observations tend to validate the single radius design of the Scorpio TKA that increases the extensor mechanism moment arm, thus improving extensor mechanism function and reducing femoro-patellar joint reaction force. The question of whether the specific design of the Scorpio knee arthroplasty does not require resurfacing of the patella being "patellafriendly" is unclear from the literature [24,25]. The implant modes of fixation and the type of implants (PS versus CR) did not significantly influence the overall clinical or radiological results.…”

Section: Discussionmentioning

confidence: 99%

“…The mean BMI was 29.4 kg/m² for women and 28.6 kg/m² for men. Of the 747 patients, only 135 (18.4%) had a normal BMI (18)(19)(20)(21)(22)(23)(24)(25); thus, 612 patients were overweight to severely obese.…”

Section: Patientsmentioning

confidence: 99%

Scorpio single radius total knee arthroplasty. A minimal five-year follow-up multicentric study

Borrione¹,

Bonnevialle

Mabit

et al. 2011

International Orthopaedics (SICOT)

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Purpose Our goal was to evaluate the five-year follow-up results of the Scorpio single radius total knee arthroplasty. Method We performed a retrospective study based upon a multicentre database to evaluate the minimum five-year follow-up clinical and radiological results of 747 patients (831 knees) who underwent primary Scorpio single radius total knee arthroplasty. Results The mean age of the patients was 71.9 years. At a minimal five-year follow-up, 141 patients were lost to follow-up, 83 patients had died, eight patients had undergone revision of a component, and the remaining 589 patients (602 knees) had a complete clinical and radiological evaluation after a median of six years (range, 5-8). The mean clinical component of the knee score was 92.2 points, and the mean functional component of the knee score was 76.9 points. At last follow-up, 530 of the 602 knees were rated as excellent or good. Only four knees developed patellar complications requiring revision. The survival rate at six years was 95.2%±1.9% and 98.3%±0.6 with revision for any reason and revision for mechanical failure as the end point, respectively. Conclusion This medium-term study indicates favourable clinical and radiological results for this single flexionextension radius design arthroplasty, with a low complication rate on the patellar side.

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Patellar Resurfacing Versus No Resurfacing in Scorpio Total Knee Arthroplasty

Cited by 19 publications

References 10 publications

Early outcomes of patella resurfacing in total knee arthroplasty

Early outcomes of patella resurfacing in total knee arthroplasty

Functional Performance with a Single-radius Femoral Design Total Knee Arthroplasty

Scorpio single radius total knee arthroplasty. A minimal five-year follow-up multicentric study

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