Total knee replacement and patellofemoral pain

Arbuthnot, J; McNicholas, Michael; McGurty, D. W.; Rowley, D.I.

doi:10.1016/s1479-666x(04)80006-4

Cited by 13 publications

(17 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Persistent AKP remains an important clinical issue after TKA. Its exact aetiology remains elusive, and the effects of prosthesis design, surgical technique, the degree of patellar chondromalacia, pre-operative AKP, and patellar tracking alteration on the prevalence of post-operative AKP remain undefined [16]. A previous study reported an average AKP incidence in non-resurfaced patients of 10%, versus 3.3% for resurfaced cases [17], corroborating our findings.…”

Section: Discussionsupporting

confidence: 87%

Resurfacing versus not-resurfacing the patella in one-stage bilateral total knee arthroplasty: a prospective randomized clinical trial

Wang

et al. 2019

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

PurposeResurfacing the patella in one-stage bilateral total knee arthroplasty (TKA) remains debatable. This study aimed to assess the mid-term outcomes of patients after one-stage bilateral TKA performed with and without patellar resurfacing, respectively, with at least five years of follow-up.MethodsSixty-six patients (132 knees) scheduled for first-ever one-stage bilateral TKA due to osteoarthritis received patellar resurfacing and retention, respectively, on one knee and the other, randomly selected. All patients received Scorpio NRG knee prostheses and were evaluated by radiology (anteroposterior, lateral, and axial views) pre-operatively and yearly post-operatively, for at least five years. Knee Society Score and Feller Score values were measured. Anterior knee pain, patellar clunk, and patient satisfaction were assessed.ResultsOne patient died within five years of operation and four were lost to follow-up. One patient developed severe dementia and could not be constructively questioned. Therefore, 60 patients (120 knees) were finally analyzed. There were significantly improved Knee Society and Feller scores (P < 0.001) in the resurfacing group compared with the non-resurfacing group post-operatively. Anterior knee pain and patellar clunk rates were lower on the resurfaced side compared with the non-resurfaced side (P < 0.001). Meanwhile, 47% and only 7% patients preferred the resurfaced and non-resurfaced sides, respectively, at final follow-up. No revision was performed for patellofemoral complications, and no significant differences were found between the two groups in radiographic outcomes.ConclusionsUsing the Scorpio NRG knee prosthesis, patellar resurfacing is superior to non-resurfacing in patients with osteoarthritis observed for ≥ five years.Registration trials number NCT03600922 Key Points• Findings Patellar resurfacing is superior to non-resurfacing in osteoarthritis (OA) patients undergoing total knee arthroplasty (TKA) with the Scorpio NRG knee prosthesis.• Implications Patellar resurfacing should be performed in OA patients during TKA.• Caution Several prosthesis types should be assessed in the same study setting, and multicenter studies are required before generalizability of the present findings.Electronic supplementary materialThe online version of this article (10.1007/s00264-019-04361-7) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 87%

Resurfacing versus not-resurfacing the patella in one-stage bilateral total knee arthroplasty: a prospective randomized clinical trial

Wang

et al. 2019

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…25 Whether this difference arises from our relatively short follow-up warrants further attention. Some authors 4,35 have reported a gradual decrease in anterior knee pain after TKR, whereas others have described an increase over time. 36 In order to assess the long-term outcome, we will re-evaluate our patients to determine whether the clinical effect of circumpatellar electrocautery diminishes with time.…”

Section: Discussionmentioning

confidence: 99%

A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing

Jonbergen

Scholtes

Kampen

et al. 2011

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

The efficacy of circumpatellar electrocautery in reducing the incidence of post-operative anterior knee pain is unknown. We conducted a single-centre, outcome-assessor and patient-blinded, parallel-group, randomised, controlled trial to compare circumpatellar electrocautery with no electrocautery in total knee replacement in the absence of patellar resurfacing. Patients requiring knee replacement for primary osteoarthritis were randomly assigned circumpatellar electrocautery (intervention group) or no electrocautery (control group). The primary outcome measure was the incidence of anterior knee pain. A secondary measure was the standardised clinical and patient-reported outcomes determined by the American Knee Society scores and the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. A total of 131 knees received circumpatellar electrocautery and 131 had no electrocautery. The overall incidence of anterior knee pain at follow-up at one year was 26% (20% to 31%), with 19% (12% to 26%) in the intervention group and 32% (24% to 40%) in the control group (p = 0.02). The relative risk reduction from electrocautery was 40% (9% to 61%) and the number needed to treat was 7.7 (4.3 to 41.4). The intervention group had a better mean total WOMAC score at follow-up at one year compared with the control group (16.3 (0 to 77.7) versus 21.6 (0 to 76.7), p = 0.04). The mean post-operative American Knee Society knee scores and function scores were similar in the intervention and control groups (knee score: 92.4 (55 to 100) versus 90.4 (51 to 100), respectively (p = 0.14); function score: 86.5 (15 to 100) versus 84.5 (30 to 100), respectively (p = 0.49)). Our study suggests that in the absence of patellar resurfacing electrocautery around the margin of the patella improves the outcome of total knee replacement.

show abstract

“…Misra et al [23] wrote that anterior knee pain after knee replacement is independent of patella resufacing; other clinical studies with and without patellar resurfacing have reported variable results [24,25]. In the literature, the frequency of complications related to resurfacing the patella, such as maltracking, patellar fracture, patellar tendon rupture and anterior knee pain, range from 4% to 21% [26,27].…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, the frequency of complications related to resurfacing the patella, such as maltracking, patellar fracture, patellar tendon rupture and anterior knee pain, range from 4% to 21% [26,27]. Arbuthnot et al [25], Barrack [28] Even if in the LCS mobile-bearing knee patellar problems are low (fracture and subluxation occur in 2.6% of cases and radiolucent lines in 3% [17]), we believe that patellar resurfacing is responsible for potential complications and that nonresurfacing of the patella is the best choice. Recent improvements in instrumentation and careful attention to ligamentous balancing may have eliminated several of the failures seen in the past.…”

Section: Discussionmentioning

confidence: 99%