Conforming patellar button design improves outcome of total knee arthroplasty |
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| Institution: | 1. North Sydney Orthopaedic and Sports Medicine Centre, Sydney, NSW, Australia;2. University of Notre Dame, Sydney, NSW, Australia;3. The Mater Hospital, Sydney, NSW, Australia;1. Department of Orthopaedic Surgery, Centre of Head and Orthopaedics, Rigshospitalet, 2100 Copenhagen Ø, Denmark;2. Department of Orthopaedic Surgery, Clinic of Hip, Knee and Foot Surgery, Gentofte and Herlev Hospital, 2900 Hellerup, Denmark;3. Clinical Sciences, Lund University, Department of Orthopaedics, Skåne University Hospital, 221 85 Lund, Sweden;4. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark;1. The Centre for Orthopaedics, Beacon Hospital, Beacon Court, Sandyford, Dublin D18 AK67, Ireland;2. University College Dublin School of Medicine, Belfield, Dublin 4, Ireland;3. Aut Even Hospital, Freshford Road, Kilkenny, Co. Kilkenny, Ireland;1. Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Germany;2. OrthoPlus, Munich, Germany;3. 3D-Surgery, Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Germany;4. Division of Knee, Hip and Shoulder Surgery, Schoen Clinic Munich Harlaching, Academic Teaching Hospital of the Paracelsus Medical University (PMU), Salzburg, Austria;1. NorthWest Clinics, Department of Orthopaedic Surgery, Alkmaar, the Netherlands;2. Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam, the Netherlands;3. Spaarne Gasthuis, Department of Orthopaedic Surgery, Hoofddorp, the Netherlands;4. Medical Clinics Velsen, Department of Orthopaedic Surgery, Velsen, the Netherlands;5. Amsterdam UMC, University of Amsterdam, Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, the Netherlands;6. Amsterdam UMC, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), University of Amsterdam and Vrije Universiteit Amsterdam IOC Research Center, Amsterdam, the Netherlands;1. Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;2. Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan;3. Department of Information Systems, Faculty of Engineering, Saitama Institute of Technology, 1690 Fusaiji, Fukaya, Saitama 369-0293, Japan;1. 2nd Orthopaedic Clinic, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy;2. Umberto I Hospital, Enna, Italy |
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| Abstract: | BackgroundPatellar resurfacing is commonly performed during total knee arthroplasty (TKA), and the patellar button design can vary within a TKA implant. Implant design is known to affect patella kinematics, contact mechanics, and ultimately the outcome of TKA. The aim of this study was to compare the patient-reported outcomes of TKA with either a conforming (CP) or medialized dome (MD) patellar component.MethodsThe study was a prospective cohort study of 100 TKAs performed between December 2015 and August 2017. We compared a consecutive series of 50 TKA subjects with a CP, with the previous 50 TKA subjects with an MD patella. The primary outcome measure was difference in Knee Injury and Osteoarthritis Score (KOOS) at 12 months. Other patient-reported outcome measures included EQ5D as a general health measure, and patient satisfaction.ResultsThere was no significant difference in baseline characteristics, KOOS, or EQ5D between the two groups. At 12 months, the CP Group had a higher mean KOOS function score (87 vs. 80, P = 0.04), and greater patient satisfaction (98% vs. 82% satisfied, P = 0.009) compared with the MD group. The CP Group had significantly lower frequency of pain with level walking, less difficulty with stairs, and lower mean EQ5D mobility at 12 months compared with the MD group.ConclusionsTKA performed using a conforming patella has superior results over a medialized dome patellar component for KOOS function, patient satisfaction, walking pain, stair performance, and mobility at 12 months postoperatively. The differences observed with the change in patellar design may be unique to this prosthesis. |
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| Keywords: | Patella button Anatomic Conforming Medialized dome Patient-reported outcomes Arthroplasty |
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