Outcomes and analysis of total knee arthroplasty with non-patella resurfacing techniques for patients with osteoarthritis of the knee in a subpopulation of Western India

  • Dr. Umang R Barot Post Graduate Resident, Department of Orthopaedics, Ruby Hall Clinic, Pune, Maharashtra, India
  • Dr. Milan M. Chaudhari Post Graduate Resident, Patan Janta Hospital & Research Foundation, Sardar Road, Near Railway Station, Patan, Gujarat, India
  • Dr. Kavyansh Bhan Post Graduate Resident, Department of Orthopaedics, Ruby Hall Clinic, Pune, Maharashtra, India
DOI: https://doi.org/10.17511/ijoso.2019.i03.14
Keywords: Non-patellar resurfacing, Osteoarthritis, Total knee arthroplasty

Abstract

Introduction: The decision to resurface the patella during total knee arthroplasty remains controversial. Even though some surgeons routinely resurface the patella to avoid the increased rates of postoperative anterior knee pain and reoperation for secondary resurfacing, others selectively resurface based on the presence of anterior knee pain, notably damaged articular cartilage, inflammatory arthritis, isolated patellofemoral arthritis, and patellar subluxation and maltracking. It is often said that there is no difference in clinical and functional outcome of Total Knee Arthroplasty (TKA) for knee osteoarthritis using patellar resurfacing and non-resurfacing techniques. Thus, this study was performed to evaluate the outcome of non-patella resurfacing total knee arthroplasty.

Materials and Methods: A total of 50 patients in series who came to Ruby Hall Clinic, Pune with clinical signs and symptoms of osteoarthritis confirmed radiologically, were operated. The functional and clinical outcomes with Knee society score and VAS score were measured.

Results: There was significant difference in outcome of non-resurfaced patella pre-operatively and post-operatively. There was significant improvement in mean range of motion (ROM). It was 87.2 Pre-op vs 104.4 Post-op. The Knee Society Score (KSS) had a mean Pre-op 39.66 v/s Post-op 83.26. The improvement in functional score was from a Pre-op 52.5 to post-op of 83.36. The mean Visual Analogue Score (VAS) score decreased from 7.98 to 2.

Conclusion: The results showed significant difference in both the main indicators of Knee Society Score (KSS) and Visual Analogue Score (VAS), both pre-operatively and post-operatively.

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References

1. Rae PJ, Noble J, Hodgkinson JP. Patellar resurfacing in total condylar knee arthroplasty: technique and results. J Arthroplast. 1990; 5 (3): 259-265. doi.org/10. 1016 /S0883-5403(08)80081-2

2. Webster DA, Murray DG. Complications of Variable Axis total knee arthroplasty. Clin Orthop Relat Res. 1985; (193):160-167.

3. Levai JP, McLeod HC, Freeman MA. Why not resurface the patella? J Bone Joint Surg Br. 1983; 65 (4): 448-451.

4. Ranawat CS. The patellofemoral joint in total condylar knee arthroplasty. Pros and cons based on five- to ten-year follow-up observations. Clin Orthop Relat Res. 1986;(205):93-99.

5. Abraham W, Buchanan JR, Daubert H, Greer RB 3rd, Keefer J. Should the patella be resurfaced in total knee arthroplasty? Efficacy of patellar resurfacing. Clin Orthop Relat Res. 1988;(236):128-134.

6. Brick GW, Scott RD. The patellofemoral component of total knee arthroplasty. Clin Orthop Relat Res. 1988; (231):163-178.

7. Keblish PA, Varma AK, Greenwald AS. Patellar resurfacing or retention in total knee arthroplasty. A prospective study of patients with bilateral replacements. J Bone Joint Surg Br. 1994; 76 (6):930-937.

8. Levitsky KA, Harris WJ, McManus JA, Scott RD. Total knee arthroplasty without patellar resurfacing. Clinical outcomes and long-term follow-up evaluation. Clinical orthopaedics and related research. 1993; (286): 116-121.

9. Picetti GD 3rd, McGann WA, Welch RB. The patellofemoral joint after total knee arthroplasty without patellar resurfacing. J Bone Joint Surg Am. 1990;72 (9): 1379-1382.

10. Scott RD, Reilly DT. Pros and cons of patellar resurfacing in total knee replacement. Orthop Trans. 1980; 4:328.

11. Soudry M, Mestriner CA, Binazzi R, Insall JN. Total knee arthroplasty without patella resurfacing. Clin Orthop 1986;205:166-170.

12. Bayley JC, Scott RD, Ewald FC, Holmes GB Jr. Failure of the metal-backed patellar component after total knee replacement. J Bone Joint Surg Am. 1988; 70(5): 668-674.

13. Insall JN, Ranawat CS, Aglietti P, Shine J. A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am. 1976;58(6):754-765.

14. Lynch AF, Rorabeck CH, Bourne RB. Extensor mechanism complications following total knee arthroplasty. J Arthroplasty. 1987;2(2):135-140.

15.Smith AJ, Wood DJ, Li MG. Total knee replacement with and without patellar resurfacing: a prospective, randomised trial using the profix total knee system. J Bone Joint Surg Br. 2008; 90(1):43-49. doi:10. 1302/ 0301-620X.90B1.18986

16. Kaseb MH, Tahmasebi MN, Mortazavi SJ, Sobhan MR, Nabian MH. Comparison of Clinical Results between Patellar Resurfacing and Non-resurfacing in Total Knee Arthroplasty: A Short-Term Evaluation. Arch Bone Jt Surg. 2018;6(2):124-129.

17. Burnett RS, Boone JL, McCarthy KP, Rosenzweig S, Barrack RL. A prospective randomized clinical trial of patellar resurfacing and nonresurfacing in bilateral TKA. Clinic Orthopaed Relat Res (1976-2007). 2007; 464:65-72. doi: 10.1097/BLO.0b013e31812f783b

18. Vora J, Vala P, Gandhi S, Parikh D, Shah R. Results, clinical outcome and analysis of non-patella resurfacing total knee arthroplasty in osteo arthritis knee. Indian J Orthop Rheumatol 2019;5(1):8-10 doi: 10.18231/j.ijor.2019.002
CITATION
DOI: 10.17511/ijoso.2019.i03.14
Published: 2019-08-31
How to Cite
R Barot, U., M. Chaudhari, M., & Bhan, K. (2019). Outcomes and analysis of total knee arthroplasty with non-patella resurfacing techniques for patients with osteoarthritis of the knee in a subpopulation of Western India. Surgical Review: International Journal of Surgery, Trauma and Orthopedics, 5(3), 222-226. https://doi.org/10.17511/ijoso.2019.i03.14
Issue
Vol 5 No 3 (2019): Jul-Aug
Section
Original Article