The influence of patellar resurfacing on patellar kinetics and retropatellar contact characteristics

Wurm, Simone; Kainz, Hans; Reng, Wolfgang; Augat, Peter

doi:10.1007/s00776-012-0326-5

Cited by 8 publications

(4 citation statements)

References 31 publications

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“…There are various methods for measuring patellofemoral joint pressure [8][9][10][11][12][13][14][15][16]. In the method of measuring pressure by placing a sensor between the patellofemoral joint, the pressure sensor may shift, and the patellofemoral joint pressure may be increased due to the thickness of the pressure sensor [8,9,11,12]. On the other hand, with a pressure sensor built into the patella, patellofemoral joint pressure can be measured accurately [13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…With respect to patellofemoral joint pressure, it is still in its infancy and no commercially available device capable of measuring patellofemoral joint pressure is available on the market to date. Various studies have been conducted on patellofemoral joint pressure by incorporating thin pressure sensors into implants and using nite element methods and inverse dynamics to analyze the pressure at the patellofemoral joint [8][9][10][11][12][13][14][15][16]. The clinical signi cance of patellofemoral joint pressure remains unclear, but it may be associated with, for example, implant wear, loosening, and anterior knee joint pain [5,6,14].…”

Section: Introductionmentioning

confidence: 99%

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Influence of Patella Thickness on Patellofemoral Pressure in Total Knee Arthroplasty

Tanikawa¹,

Tada

Ogawa

et al. 2020

Preprint

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Background: Patellofemoral complications are one of the major issues after total knee arthroplasty (TKA). Excessive patellofemoral joint pressure is associated with complications after TKA surgery, and the amount of patellar osteotomy has a direct effect on patellofemoral joint pressure. The purpose of this study was to evaluate the influence of patella thickness on patellofemoral pressure in TKA.Methods. Five freshly frozen cadavers were operated with a custom-made Stryker posterior stabilizing type knee joint prosthesis. Patellofemoral joint pressure was measured using a pressure sensor, with the knee joint flexed from 90 to 110 degrees, and with patellar thickness of -2mm to +4mm.Results: Increasing or decreasing patellar thickness significantly increased or decreased patellofemoral pressure. Regarding knee flexion angle, patellofemoral pressure increased with increasing patellar thickness at all flexion angles, but the pressure increase was greatest at 90 degrees of knee flexion and smallest at 110 degrees.Conclusions: The amount of patellar osteotomy influences the patellofemoral pressure. Surgeons should avoid increasing patella thickness, since the resulting increased patellofemoral pressure may reduce knee joint function.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of Patella Thickness on Patellofemoral Pressure in Total Knee Arthroplasty

Tanikawa¹,

Tada

Ogawa

et al. 2020

Preprint

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“…This large range highlights the variation of surgeon opinion and decades of research has provided little to no conclusive evidence for best standard of practice for patella resurfacing. Evidence against routine patella resurfacing primarily includes cadaveric and anatomic studies, reporting abnormal kinematics, contact areas and loading characteristics [2][3][4][5][6][7][8]. Conversely, several meta-analyses conclude a lower incidence of anterior knee pain and fewer revisions following routine patella resurfacing but fail to report consistent clinically meaningful differences [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Range of Motion Comparison Following Total Knee Arthroplasty with and without Patella Resurfacing

Jackels¹,

Andrews

Matsumoto³

et al. 2021

ReconRev

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Background: Despite significant evaluation, no consensus has been reach for best clinical practice for resurfacing the patella during total knee arthroplasty. Further complicating the ability to reach a conclusion is the inclusion of several different implant types used in previous research. Questions/Purpose: The purpose of this study was to compare post-TKA outcomes between two cruciate retaining implants with or without patella resurfacing. Methods: This retrospective review included 289 patients (380 knees) with a minimum six-month follow-up. All patients received a CR implant, with either a symmetric or an asymmetric tibial baseplate. Post-TKA knee flexion was categorized as <120° and ≥120° and knee extension classified as 0° or >0° and required knee manipulations were noted. Descriptive, nonparametric statistics were performed and a multivariate logistic regression was performed to determine risk of poor range of motion and manipulations. Results: Age was significantly lower in the resurfaced group (p=0.001) and the resurfaced group had longer tourniquet time (p=0.003). The symmetric-resurfaced group had ≥120° of flexion and full extension in 72% and 98.7% of patients, respectively. Compared to symmetric-resurfaced, all other groups had a significantly greater risk of not reaching 120° of knee flexion (p<0.05). There were no significant differences in the risk of requiring a MUA between groups (p>0.06). Conclusions: The effect of resurfacing the patella on post-TKA outcomes may be influenced by tibial implant design. Compared to all other combinations, a symmetric tibial baseplate and resurfaced patella resulted in the highest percentage of patients reaching ≥120°, with a low incidence of manipulations.

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“…16 In 2000, a comparative study of 185 TKAs found that resurfacing the patella during TKA did not seem to influence the clinical outcome with respect to ROM, pain, and overall complications. 17 Since then, multiple comparative studies have yielded similar results, [18][19][20][21] suggesting that routinely resurfacing the patella is neither beneficial nor necessary during TKA.…”

mentioning

confidence: 98%

Resurfaced versus Non-Resurfaced Patella in Total Knee Arthroplasty

2019

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The prevalence of knee osteoarthritis is increasing, as is the projected use of total knee arthroplasty (TKA) to treat severe cases that fail to respond to conservative measures. Implant designs are either cruciate retaining or posterior stabilized, and while both have high success rates, management of the patella still remains a controversial topic. Although studies indicate that resurfacing the patella provides no significant clinical differences compared with non-resurfacing techniques, surgeons continue to resurface the patella during TKA. Rates of patella resurfacing continue to be as high as 90% in the United States, while European countries tend to favor non-resurfacing techniques. The purpose of this article is to discuss relevant research on patella resurfacing during TKA, to compare the results, and give evidence-based recommendations on how it should be approached going forward.

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The influence of patellar resurfacing on patellar kinetics and retropatellar contact characteristics

Cited by 8 publications

References 31 publications

Influence of Patella Thickness on Patellofemoral Pressure in Total Knee Arthroplasty

Influence of Patella Thickness on Patellofemoral Pressure in Total Knee Arthroplasty

Range of Motion Comparison Following Total Knee Arthroplasty with and without Patella Resurfacing

Resurfaced versus Non-Resurfaced Patella in Total Knee Arthroplasty

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