Research Article
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Relationship between patellar resurfacing and postoperative anterior knee pain in total knee arthroplasty

Year 2024, , 267 - 271, 29.07.2024
https://doi.org/10.38053/acmj.1467002

Abstract

Aims: To retrospectively demonstrate the effect of patellar resurfacing (PR) on the clinical and functional outcomes of total knee arthroplasty (TKA).
Methods: The files of 257 patients who presented to our clinic between 2013 and 2022 and underwent TKA due to the diagnosis of grade IV gonarthrosis were screened retrospectively. Thirty-two patients were excluded due to not attending regular follow-up, receiving steroid treatment, or being morbidly obese. The sample consisted of 225 patients, of whom 123 underwent PR (Group A) and 102 did not undergo PR (Group B). The Sperner classification was used to evaluate the level of patellar arthrosis. The effect of PR on postoperative clinical and functional outcomes in patients undergoing TKA was investigated using the WOMAC knee functional scoring and Visual Analog Scale (VAS) for clinical and functional evaluation at six, 12, and 24 months postoperatively.
Results: The presence of anterior knee pain wasstatistically significantly lower in Group A than in Group B (p=0.0001). There was no statistically significant difference between the comorbidity distributions of the groups. The preoperative-to-postoperative changes in the mean VAS and WOMAC scores were statistically significantly higher in Group A compared to Group B (p=0.0001 for both).
Conclusion: The implementation of PR in TKA may vary depending on countries, clinics, and even surgeons. In the current study, PR was found to contribute positively to the clinical and functional outcomes of patients by preventing complications such as anterior knee pain that may develop due to patellar arthrosis in the postoperative period.

Ethical Statement

Ethical approval was obtained from the Ethics Committee of the Sakarya University Faculty of Medicine on January 31, 2023, with document number E-71522473-050.01.04-216228-22.

References

  • Cameron JS, Nathan N, Solomon N, et al. Patellar resurfacing was not associated with a clinically significant advantage when a modern patellar friendly total knee arthroplasty is employed: a systematic review and meta-analysis. Knee. 2023;Mar:41:329-341.
  • Léopold J, Cécile B, Julien R, John S, Elvire S, Sébastien L. Patellar component size effects patellar tilt in total knee arthroplasty with patellar resurfacing. Knee Surg Sports Traumatol Arthrosc. 2021;29(2):553-562.
  • Zhenguo Y, Hong C, Zhongjun L. Factors that impact the patellofemoral contact stress in the TKA: a review. Arthroplasty. 2023;5(1):44.
  • Alisara A , Chanchit S, Jatupon K. Patellofemoral resurfacing and patellar denervation in primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2015;23(6):1770-1781.
  • Valenti E ,Scita G, Ceccarelli F, Pogliacomi F. Understanding the human knee and its relationship to total knee replacement. Acta Biomed. 2017;88(2):6-16.
  • Lee TQ,  Budoff JE,  Glaser FE. Patellar component positioning in total knee arthroplasty. Clin Orthop Relat Res. 1999;(366):274-281.
  • McConaghy K , Derr T, Molley RM , et al. .Patellar management during total knee arthroplasty: a review. Efort Open Rev. 2021;6(10):861-871.
  • Shervin D, Pratt K, Healey T, et al. Anterior knee pain following primary total knee arthroplasty. World J Orthop. 2015;18;6(10):795-803.
  • Aktı S, Çankaya D, Kılınç S, Öztemur Z, Öztürk H, Bulut O. Effect of patellar resurfacing surgery on bleeding in total knee arthroplasty. Rev Assoc Med Bras. 2022;28(68):1542-1546.
  • Schindler OS. The controversy of patellar resurfacing in total knee arthroplasty: ibisne in medio tutissimus? Knee Surg Sports Traumatol Arthrosc. 2012;20(7):1227-44.
  • Benazzo F , Perticarini L , Jannelli E , Ivone A , Ghiara M , Rossi SMP.  Controversy: supporting patellar resurfacing in total knee arthroplasty - do it. Efort Open Rev. 2020;13;5(11):785-792.
  • Ali A, Lindstrand A, Nilsdotter A, Sundberg M. Similar patient-reported outcomes and performance after total knee arthroplasty with or without patellar resurfacing. Acta Orthop.  2016;87(3):274-279.
  • Huang YF, Gau YH, Ding L, Liu B,  Liu JG, Xin Q. .Influence of femoral implant design modification on anterior knee pain and patellar crepitus in patients who underwent total knee arthroplasty without patella resurfacing. BMC Musculoskelet Disord. 2020;21(1):364.
  • Matz J, Lanting B A , Howard J L. Understanding the patellofemoral joint in total knee arthroplasty. Can J Surg. 2019;1;62(1):57-65.
  • Peterson W, Rembitzki IV, Brüggemann GP, et al. Anterior knee pain after total knee arthroplasty: a narrative review. Int Orthop. 2014;38(2):319-328.
  • Sauer A, Thorwaechter C, Dupraz I, et al.  Isolated effects of patellar resurfacing in total knee arthroplasty and their relation to native patellar geometry. Sci Rep. 2022;28;12(1):12979.
  • Panni AS, Cerciello S, Regno CD, Felicive A, Vasso M. Patellar resurfacing complications in total knee arthroplasty. Int Orthop. 2014;38(2):313-317.
  • Fuchs  S, Schütte G,  Witte H,  Rosenbaum D. What influence do size and placement of patella resurfacing have on knee endoprosthesis? Unfallchirurg. 2002;105(1):44-48.
  • Fleaca SR, Mohor CI, Dura H, et al. Effect of patella resurfacing on functional outcome and revision rate in primary total knee arthroplasty. Exp Ther Med. 2022;23(1):104.
  • Sato D, Inoue M, Sasaki T, et al. No patella resurfacing total knee arthroplasty leads to reduction in the thickness of patellar cartilage to less than half within 5 years: a quantitative longitudinal evaluation using MRI. J Exp Orthop. 2021;24;8(1):107.
  • Parvizi J, Mortazavi SJ, Devulapalli C, Hozack WJ, Sharkey PF, Rothman RH.. Secondary resurfacing of the patella after primary total knee arthroplasty does the anterior knee pain resolve? J Arthroplasty. 2012;27(1):21-26.
  • Ertürk C,  Altay MA, Işıkan UE. Patelloplasty with patellar decompression to relieve anterior knee pain in total knee arthroplasty. Acta Orthop Traumatol Turc. 2011;45(6):425-430.
Year 2024, , 267 - 271, 29.07.2024
https://doi.org/10.38053/acmj.1467002

Abstract

References

  • Cameron JS, Nathan N, Solomon N, et al. Patellar resurfacing was not associated with a clinically significant advantage when a modern patellar friendly total knee arthroplasty is employed: a systematic review and meta-analysis. Knee. 2023;Mar:41:329-341.
  • Léopold J, Cécile B, Julien R, John S, Elvire S, Sébastien L. Patellar component size effects patellar tilt in total knee arthroplasty with patellar resurfacing. Knee Surg Sports Traumatol Arthrosc. 2021;29(2):553-562.
  • Zhenguo Y, Hong C, Zhongjun L. Factors that impact the patellofemoral contact stress in the TKA: a review. Arthroplasty. 2023;5(1):44.
  • Alisara A , Chanchit S, Jatupon K. Patellofemoral resurfacing and patellar denervation in primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2015;23(6):1770-1781.
  • Valenti E ,Scita G, Ceccarelli F, Pogliacomi F. Understanding the human knee and its relationship to total knee replacement. Acta Biomed. 2017;88(2):6-16.
  • Lee TQ,  Budoff JE,  Glaser FE. Patellar component positioning in total knee arthroplasty. Clin Orthop Relat Res. 1999;(366):274-281.
  • McConaghy K , Derr T, Molley RM , et al. .Patellar management during total knee arthroplasty: a review. Efort Open Rev. 2021;6(10):861-871.
  • Shervin D, Pratt K, Healey T, et al. Anterior knee pain following primary total knee arthroplasty. World J Orthop. 2015;18;6(10):795-803.
  • Aktı S, Çankaya D, Kılınç S, Öztemur Z, Öztürk H, Bulut O. Effect of patellar resurfacing surgery on bleeding in total knee arthroplasty. Rev Assoc Med Bras. 2022;28(68):1542-1546.
  • Schindler OS. The controversy of patellar resurfacing in total knee arthroplasty: ibisne in medio tutissimus? Knee Surg Sports Traumatol Arthrosc. 2012;20(7):1227-44.
  • Benazzo F , Perticarini L , Jannelli E , Ivone A , Ghiara M , Rossi SMP.  Controversy: supporting patellar resurfacing in total knee arthroplasty - do it. Efort Open Rev. 2020;13;5(11):785-792.
  • Ali A, Lindstrand A, Nilsdotter A, Sundberg M. Similar patient-reported outcomes and performance after total knee arthroplasty with or without patellar resurfacing. Acta Orthop.  2016;87(3):274-279.
  • Huang YF, Gau YH, Ding L, Liu B,  Liu JG, Xin Q. .Influence of femoral implant design modification on anterior knee pain and patellar crepitus in patients who underwent total knee arthroplasty without patella resurfacing. BMC Musculoskelet Disord. 2020;21(1):364.
  • Matz J, Lanting B A , Howard J L. Understanding the patellofemoral joint in total knee arthroplasty. Can J Surg. 2019;1;62(1):57-65.
  • Peterson W, Rembitzki IV, Brüggemann GP, et al. Anterior knee pain after total knee arthroplasty: a narrative review. Int Orthop. 2014;38(2):319-328.
  • Sauer A, Thorwaechter C, Dupraz I, et al.  Isolated effects of patellar resurfacing in total knee arthroplasty and their relation to native patellar geometry. Sci Rep. 2022;28;12(1):12979.
  • Panni AS, Cerciello S, Regno CD, Felicive A, Vasso M. Patellar resurfacing complications in total knee arthroplasty. Int Orthop. 2014;38(2):313-317.
  • Fuchs  S, Schütte G,  Witte H,  Rosenbaum D. What influence do size and placement of patella resurfacing have on knee endoprosthesis? Unfallchirurg. 2002;105(1):44-48.
  • Fleaca SR, Mohor CI, Dura H, et al. Effect of patella resurfacing on functional outcome and revision rate in primary total knee arthroplasty. Exp Ther Med. 2022;23(1):104.
  • Sato D, Inoue M, Sasaki T, et al. No patella resurfacing total knee arthroplasty leads to reduction in the thickness of patellar cartilage to less than half within 5 years: a quantitative longitudinal evaluation using MRI. J Exp Orthop. 2021;24;8(1):107.
  • Parvizi J, Mortazavi SJ, Devulapalli C, Hozack WJ, Sharkey PF, Rothman RH.. Secondary resurfacing of the patella after primary total knee arthroplasty does the anterior knee pain resolve? J Arthroplasty. 2012;27(1):21-26.
  • Ertürk C,  Altay MA, Işıkan UE. Patelloplasty with patellar decompression to relieve anterior knee pain in total knee arthroplasty. Acta Orthop Traumatol Turc. 2011;45(6):425-430.
There are 22 citations in total.

Details

Primary Language English
Subjects Orthopaedics
Journal Section Research Articles
Authors

Bedrettin Akar 0000-0001-7461-1777

Fatih Uğur 0000-0001-6109-8425

Tolga Kaplan 0000-0002-4716-4083

Mehmet Albayrak 0000-0002-4074-7024

Early Pub Date July 27, 2024
Publication Date July 29, 2024
Submission Date April 8, 2024
Acceptance Date June 16, 2024
Published in Issue Year 2024

Cite

AMA Akar B, Uğur F, Kaplan T, Albayrak M. Relationship between patellar resurfacing and postoperative anterior knee pain in total knee arthroplasty. Anatolian Curr Med J / ACMJ / acmj. July 2024;6(4):267-271. doi:10.38053/acmj.1467002

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