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Patellar facet ratio affects knee pain, stair climbing and stair descent after TKA without patellar resurfacing

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To determine whether knee pain or functional impairment after total knee arthroplasty (TKA) without patellar resurfacing are correlated with preoperative patellar morphology or postoperative patellar orientation. The hypotheses were that patellar shape, increased tilt and lateral displacement would be associated with pain and functional impairment.

Methods

From a consecutive series of 152 knees that received a cemented postero-stabilized TKA, the Oxford Knee Score (OKS) and the Knee injury and Osteoarthritis Outcome Score (KOOS) were collected at a minimum follow-up of 12 months. Uni- and multi-variable linear regression analyses were performed to determine associations between the collected clinical scores and patient demographics and patellar morphology, measured from pre- and post-operative frontal, lateral and skyline view radiographs.

Results

The OKS was 75 ± 23, whereas the KOOS pain, stair climbing, and descent were respectively 77 ± 24, 3.9 ± 1.1 and 3.8 ± 1.2. OKS was not associated with any radiographic outcomes, whereas KOOS pain was better for knees with larger medial patellar facets. The KOOS stair climbing and descent were also better for knees with larger medial patellar facets.

Conclusion

The findings of this study partly confirm the hypotheses that pain and functional impairments after TKA without patellar resurfacing are associated with patellar shape. No association was revealed between postoperative patellar orientation and function nor pain. Quantitative consideration of patellar congruency could therefore prevent pain and improve function after TKA without patellar resurfacing.

Level of evidence

Retrospective study, Level III.

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Acknowledgements

The authors would like to thank Jeremy Valluy and Luca Nover for their support in statistical analysis and manuscript preparation.

Funding

The authors are grateful to Ramsay Santé for funding the statistical analysis and manuscript preparation for this study.

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Authors and Affiliations

Authors

Contributions

TASS: study design, data collection, manuscript editing. LMH: data collection, manuscript editing. PFOL: data collection, manuscript editing. KK: data collection, manuscript editing. JHM: literature review, statistical analysis, manuscript writing, figures and tables. MS: study design, literature review, manuscript writing. MPB: study design, data collection, manuscript editing.

Corresponding author

Correspondence to Mo Saffarini.

Ethics declarations

Conflict of interest

TASS: Receives royalties and fees from DePuy-Synthes and Symbios. LMH: Nothing to declare. PFOL: Nothing to declare. KK: Nothing to declare. JHM: Consults and receives fees from ReSurg. MS: Consults and receives fees from ReSurg. MPB: Receives royalties from DePuy-Synthes, Wright Medical, Integra and Symbios.

Ethical approval

All patients had provided written informed consent for the use of their data and images for research and publishing purposes and the institutional review board approved the study in advance (IRB reference number: COS-RGDS-2019-06-002-AIT SI SELMI-T).

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Aït-Si-Selmi, T., Marie-Hardy, L., O’Loughlin, P.F. et al. Patellar facet ratio affects knee pain, stair climbing and stair descent after TKA without patellar resurfacing. Knee Surg Sports Traumatol Arthrosc 28, 3796–3804 (2020). https://doi.org/10.1007/s00167-020-05868-y

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  • DOI: https://doi.org/10.1007/s00167-020-05868-y

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