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

Graulich, Tilman; Kranz, Caroline; Zhang, Dafang; Örgel, Marcus; Pacha, Tarek Omar; Haertlé, Marco; Omar, Mohamed; Krettek, Christian; Panzica, Martin

doi:10.21873/invivo.11887

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…22–24 However, recent studies have shown that patella baja does not affect the patient’s postoperative ROM. 25 , 26 In our study, patella baja (P>0.05) was also not an influencing factor of squatting. Bellemans et al 27 defined a parameter termed “posterior condylar offset.” They found that PCO was associated with a postoperative change in flexion angle in CR knees, whereas this correlation was not observed in PS knees.…”

Section: Discussioncontrasting

confidence: 45%

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Factors Affecting Squatting Ability in Total Knee Arthroplasty Using High Flexion Prosthesis

Li¹,

Sun²,

Du³

et al. 2021

TCRM

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Purpose: Total knee arthroplasty (TKA) is widely used as a treatment for knee osteoarthritis. Few studies have analysed the factors affecting the squatting ability of patients after TKA. The purpose of this study was to comprehensively analyse the factors affecting squatting ability after TKA and to determine which ones are important. Patients and Methods: Three hundred primary TKA cases with a minimum 3-year followup were retrospectively analysed. All patients received a conventional posterior-stabilized TKA implant and underwent a standard perioperative care pathway. The patients were divided into two groups according to the squatting position and knee flexion angle while weight-bearing (Group I -inability to squat group, Group II -ability to squat group). Demographic, operative, and clinical data were collected. Radiographic assessment included joint line elevation, patellar position, posterior condylar offset (PCO), etc. Statistical analysis of the effect of all the above factors on squatting ability was performed. Results: The preoperative range of motion and joint line of Group I were 82.9±12.6 and 3.24±1.07, respectively, and those of Group II were 107±9.6 and 1.83±0.89 respectively. The univariate analysis showed that age, prosthesis size, preoperative ROM and joint line position were correlated with squatting ability. But in the final multivariate analysis, joint line position and preoperative ROM were independent influencing factors that affected squatting ability after TKA (p value < 0.01). Conclusion:Preoperative ROM and joint line position were independent influencing factors affecting squatting ability after TKA. Patients should be counseled accordingly and be made to understand these factors. To ensure that patients can squat postoperatively, we should improve surgical techniques to control joint line elevation.

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Section: Discussioncontrasting

confidence: 45%

“…[22][23][24] However, recent studies have shown that patella baja does not affect the patient's postoperative ROM. 25,26 In our study, patella baja (P>0.05) was also not an influencing factor of squatting. Bellemans et al 27 defined a parameter termed "posterior condylar offset."…”

contrasting

confidence: 44%

Factors Affecting Squatting Ability in Total Knee Arthroplasty Using High Flexion Prosthesis

Li¹,

Sun²,

Du³

et al. 2021

TCRM

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“…There were also many reports in the literature that patella baja can restrict the ROM of the knee (21)(22)(23). However, recent studies had shown that patella baja doesn't affect the patient's postoperative range of motion (24,25). In our study, patella baja(P 0. the patients in our study were all PS knees, which also explained why PCO had no effect on the postoperative squatting ability in our ndings.…”

Section: Discussionmentioning

confidence: 42%

Factors Affecting Squatting Ability in Total Knee Arthroplasty Using High Flexion Prosthesis

Sun

et al. 2021

Preprint

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Background: Total knee arthroplasty (TKA) is widely used as a treatment for knee osteoarthritis. Few studies have analyzed the factors affecting squatting ability of patients after TKA. The purpose of this study is to comprehensively analyze the factors affecting squatting ability after TKA and to determine which important factors should be paid attention to.Methods: Three hundred primary TKA cases with a minimum 3-year follow-up were retrospectively analyzed. All patients received a conventional posterior-stabilized TKA implant and underwent a standard perioperative care pathway. The patients were divided into two groups according to the knee flexion angle (Group I -squatting group, Group II - inability squatting group). Demographic, operative, and clinical data were collected. Radiographic assessment included joint line joint line elevation, patella position, posterior condylar offset (PCO) , etc. Statistical analysis of effect of all the above factors on squatting ability was done. Results: The univariate analysis showed age, prosthesis size, preoperative ROM and joint line position were correlated with squatting ability (p-values ≤0.10). In the final multivariate analysis, joint line position and preoperative ROM were independent influencing factors that affecting squatting ability after TKA (p-values < 0.01). Conclusion: Preoperative ROM and joint line position were independent influencing factors affecting squatting ability after TKA. Patients should be counseled accordingly and made to understand these factors. In order to ensure patients can squat postoperatively, we should improve surgical techniques to control joint line elevation.

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“…Outside of oncologic reconstructions, the indications to use a PTR are limited. In cases with insufficient support for reconstruction in zone 2, a PTR should be used as a last resort, given that outcomes and survivorship are worse when PTRs are used [26,77,83,93]. It should be noted that cases with complex and massive tibial bone loss may also have insufficient soft tissue coverage, and a muscle flap may be required for coverage in this area of a reconstruction to decrease the chances of failure secondary to wound breakdown.…”

Section: Panel 4: Considerations Regarding Complex Modular Replacemen...mentioning

confidence: 99%

Management of Bone Loss in Revision Total Knee Arthroplasty: An International Consensus Symposium

Sculco,

Flevas,

Jerabek

et al. 2024

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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The evaluation, classification, and treatment of significant bone loss after total knee arthroplasty (TKA) continue to be a complex and debated topic in revision TKA (rTKA). Despite the introduction of new evidence and innovative technologies aimed at addressing the approach and care of severe bone loss in rTKA, there is no single document that systematically incorporates these newer surgical approaches. Therefore, a comprehensive review of the treatment of severe bone loss in rTKA is necessary. The Stavros Niarchos Foundation Complex Joint Reconstruction Center Hospital for Special Surgery, dedicated to clinical care and research primarily in revision hip and knee replacement, convened a Management of Bone Loss in Revision TKA symposium on June 24, 2022. At this meeting, the 42 international invited experts were divided into groups; each group was assigned to discuss questions related to 1 of the 4 topics: (1) assessing preoperative workup and imaging, anticipated bone loss, classification system, and implant surveillance; (2) achieving durable fixation in the setting of significant bone loss in revision TKA; (3) managing patellar bone loss and the extensor mechanism in cases of severe bone loss; and (4) considering the use of complex modular replacement systems: hinges, distal femoral, and proximal tibial replacements. Each group came to consensus, when possible, based on an extensive literature review and interactive discussion on their group topic. This document reviews each these 4 areas, the consensus of each group, and directions for future research.

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

Cited by 3 publications

References 23 publications

Factors Affecting Squatting Ability in Total Knee Arthroplasty Using High Flexion Prosthesis

Factors Affecting Squatting Ability in Total Knee Arthroplasty Using High Flexion Prosthesis

Factors Affecting Squatting Ability in Total Knee Arthroplasty Using High Flexion Prosthesis

Management of Bone Loss in Revision Total Knee Arthroplasty: An International Consensus Symposium

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