Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing

Takahashi, Atsushi; Kamimura, Mikio; Sano, Hirotaka; Kashiwaba, Mitsuhiro; Ohnuma, Masahiro; Itoi, Eiji

doi:10.1007/s00776-014-0570-y

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…19 Several non-ML studies aimed to identify patients at high risk of revision surgery to optimize those patients preoperatively with the overall goal of improving clinical survivorship of primary noncemented THA in osteoporotic patients. 20,21 The Fracture Risk Assessment Tool (FRAX), developed by the World Health Organization, is commonly used as an assessment modality to calculate the 10-year probability of hip fracture and a major osteoporotic fracture (spine, forearm, hip, or shoulder). 22 A recent study by Moya et al 23 has reported that the FRAX was a useful tool to assess the risk of future major osteoporotic fractures in old total knee arthroplasty (TKA)-bearing patients; however, FRAX has not still been proven to predict the risk of revision after primary noncemented THA in osteoporotic patients.…”

Section: Discussionmentioning

confidence: 99%

Artificial Neural Networks Can Predict Early Failure of Cementless Total Hip Arthroplasty in Patients With Osteoporosis

Cohen-Levy¹,

Melnic²,

Kwon³

2022

J Am Acad Orthop Surg

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Background: Total hip arthroplasty (THA) done in the aging population is associated with osteoporosis-related complications. The altered bone density in osteoporotic patients is a risk factor for revision surgery. This study aimed to develop and validate machine learning (ML) models to predict revision surgery in patients with osteoporosis after primary noncemented THA. Methods: We retrospectively reviewed a consecutive series of 350 patients with osteoporosis (T-score less than or equal to 22.5) who underwent primary noncemented THA at a tertiary referral center. All patients had a minimum 2-year follow-up (range: 2.1 to 5.6). Four ML algorithms were developed to predict the probability of revision surgery, and these were assessed by discrimination, calibration, and decision curve analysis. Results: The overall incidence of revision surgery was 5.2% at a mean follow-up of 3.7 years after primary noncemented THA in osteoporotic patients. Revision THA was done because of periprosthetic fracture in nine patients (50%), aseptic loosening/subsidence in five patients (28%), periprosthetic joint infection in two patients (11%) and dislocation in two patients (11%). The strongest predictors for revision surgery in patients after primary noncemented THA were female sex, BMI (.35 kg/m 2 ), age (.70 years), American Society of Anesthesiology score ($3), and T-score. All four ML models demonstrated good model performance across discrimination (AUC range: 0.78 to 0.81), calibration, and decision curve analysis. Conclusion:The ML models presented in this study demonstrated high accuracy for the prediction of revision surgery in osteoporotic patients after primary noncemented THA. The presented ML models have the potential to be used by orthopaedic surgeons for preoperative patient counseling and optimization to improve the outcomes of primary noncemented THA in osteoporotic patients.

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Section: Discussionmentioning

confidence: 99%

Artificial Neural Networks Can Predict Early Failure of Cementless Total Hip Arthroplasty in Patients With Osteoporosis

Cohen-Levy¹,

Melnic²,

Kwon³

2022

J Am Acad Orthop Surg

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“…The causes of AKP after TKR might not only involved thickness of patella, but also mal-rotation of the component [14,24], and degrees of varus or valgus deformity after the operation [25]. A study suggested that postoperative AKP is related either to the component design or to the details of the surgical technique, such as component rotation, rather than to whether or not the patella is resurfaced [26].…”

Section: Discussionmentioning

confidence: 99%

Anterior Knee Pain reduction by patellar thickness reduction in Total Knee Replacement

Kantayaporn¹,

Puempanich²

2019

Arch Gerontol Geriatr Res

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Background: Anterior knee pain(AKP) was a common complication after total knee replacement(TKR). This condition can be occurred in both patellar resurfacing and non-resurfacing technique. An increase in patellar thickness 1 mm or more postoperatively was associated with lower gain in WOMAC score. Objective:To compare AKP and up and down stair function after patellar thickness reduction and patellar non-resurfacing TKR. Materials and Methods:A retrospective comparative study of was designed. All patients who had been TKR since March 2015 and December 2017 were included. The questionnaires of 2 easy questions about pain over patellar region and walking up-down stairs performance were sent to all patients by letters. The patient's characteristics were collected from inpatient medical records. AKP was defi ned as pain scale 3-10. Data were analyzed by t-test and fi sher's exact using STATA 12 (demonstrated version). P-value < 0.05 was considered signifi cant.Results: 60 questionnaires were sent and 49 evaluations were received. 26 patients were patellar non-resurfacing(PNR) group and 23 patients was patellar thickness reduction(PTR) group. Duration after TKR to questionnaires response were 12-43 months. The prevalence of AKP and knee function of up and down stair were not signifi cantly different in both groups. The severity of AKP in PNR group (5.1+1.2) was signifi cant (p-value < 0.01) higher than PTR group (3.4+0.8).Conclusion: Patellar thickness reduction in total knee replacement could reduce the severity of anterior knee pain compared to patellar non-resurfacing technique.

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Patella Replacement in Knee Arthroplasty: A Japanese Perspective

Takahashi¹

2022

Essentials of Cemented Knee Arthroplasty

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Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing

Cited by 3 publications

References 17 publications

Artificial Neural Networks Can Predict Early Failure of Cementless Total Hip Arthroplasty in Patients With Osteoporosis

Artificial Neural Networks Can Predict Early Failure of Cementless Total Hip Arthroplasty in Patients With Osteoporosis

Anterior Knee Pain reduction by patellar thickness reduction in Total Knee Replacement

Patella Replacement in Knee Arthroplasty: A Japanese Perspective

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