Controversial Topics in Total Knee Arthroplasty: A 5-Year Update (Part 1)

Merwe, Johannes Michiel van der; Mastel, Matthew Semrau

doi:10.5435/jaaosglobal-d-19-00047

Cited by 9 publications

(11 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Currently, numerous technical controversies exist, such as the choice of polyethylene insert and the necessity of performing patella resurfacing [57]. Many studies have shown no signi cant differences in anterior knee pain incidence, functional outcomes, and range of motion (ROM) after patellar resurfacing [19,21].…”

Section: Introductionmentioning

confidence: 99%

Anterior knee pain and sit-up tests predicts patients’ satisfaction and improvement in quality of life after anterior stabilized total knee replacement without patellar resurfacing

Barahona

Barrientos

Alegria

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose The purpose of this study was to assess patient satisfaction and identify risk factors for dissatisfaction after anterior stabilised conventional total knee arthroplasty (TKA) without patellar resurfacing, using the Goodman score. Methods We conducted a cross-sectional study using data from our institutional database from 1 January 2018 to 1 March 2021. Patients who underwent TKA with the Vanguard® Cruciate Retaining Anterior Stabilized Knee System (Zimmer Biomet, Warsaw, Indiana, USA) without patellar replacement were invited to participate. Patients with other bearing surfaces (posterior stabilised or medial congruent) or diagnosed with infection or instability were excluded. Patients' reported outcomes, body mass index (BMI), passive range of motion, the timed up-and-go test, sit-up test, and algometry were assessed. Patients were also asked if they had anterior knee pain. Satisfaction was assessed using the Goodman scale, and logistic multivariate regression was used to identify variables associated with dissatisfaction and a worse perceived improvement in quality of life. Results A total of 131 TKA patients were included in the study. The median satisfaction score was 100 (interquartile range [IQR], 87.5 to 100), with the 75-point threshold at the 90th percentile according to Section A of Goodman. Section B of Goodman showed that 113 TKA patients (86.26%) reported "great improvement" or "more than I ever dreamed." Multivariate logistic regression revealed that anterior knee pain (OR 5.16, 95% CI 1.24 to 21.39), the sit-up test (OR 0.63, 95% CI 0.49 to 0.81), and BMI (OR 0.84, 95% CI 0.70 to 0.99) were significantly associated with patient dissatisfaction and a worse perceived improvement in quality of life. The receiver operating characteristics curve for the models had areas under the curve of 0.83 (95% CI 0.69 to 0.97) and 0.82 (95% CI 0.70 to 0.94), respectively. Conclusion Anterior stabilised TKA without patellar resurfacing can achieve 90% satisfaction and 86% improvement in quality of life. To improve these results, it is essential to prevent and treat anterior knee pain and enhance quadriceps strength. Level of evidence: Therapeutic, Level III (retrospective cohort study).

show abstract

Section: Introductionmentioning

confidence: 99%

Anterior knee pain and sit-up tests predicts patients’ satisfaction and improvement in quality of life after anterior stabilized total knee replacement without patellar resurfacing

Barahona

Barrientos

Alegria

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The lack of consensus is likely due to the myriad of implant designs available and from which research has been conducted, which include fundamental differences in function and stability. However, previous research has suggested that cruciate retaining (CR) implants with patella resurfacing may result in a lower incidence of anterior knee pain and fewer revisions when compared to posterior stabilized implants [12,13,19]. Unfortunately, even within CR implant research, multiple implant designs are present and broad application is limited.…”

Section: Introductionmentioning

confidence: 99%

Range of Motion Comparison Following Total Knee Arthroplasty with and without Patella Resurfacing

Jackels¹,

Andrews

Matsumoto³

et al. 2021

ReconRev

View full text Add to dashboard Cite

Background: Despite significant evaluation, no consensus has been reach for best clinical practice for resurfacing the patella during total knee arthroplasty. Further complicating the ability to reach a conclusion is the inclusion of several different implant types used in previous research. Questions/Purpose: The purpose of this study was to compare post-TKA outcomes between two cruciate retaining implants with or without patella resurfacing. Methods: This retrospective review included 289 patients (380 knees) with a minimum six-month follow-up. All patients received a CR implant, with either a symmetric or an asymmetric tibial baseplate. Post-TKA knee flexion was categorized as <120° and ≥120° and knee extension classified as 0° or >0° and required knee manipulations were noted. Descriptive, nonparametric statistics were performed and a multivariate logistic regression was performed to determine risk of poor range of motion and manipulations. Results: Age was significantly lower in the resurfaced group (p=0.001) and the resurfaced group had longer tourniquet time (p=0.003). The symmetric-resurfaced group had ≥120° of flexion and full extension in 72% and 98.7% of patients, respectively. Compared to symmetric-resurfaced, all other groups had a significantly greater risk of not reaching 120° of knee flexion (p<0.05). There were no significant differences in the risk of requiring a MUA between groups (p>0.06). Conclusions: The effect of resurfacing the patella on post-TKA outcomes may be influenced by tibial implant design. Compared to all other combinations, a symmetric tibial baseplate and resurfaced patella resulted in the highest percentage of patients reaching ≥120°, with a low incidence of manipulations.

show abstract

“…1 No obstante, el dolor anterior de rodilla persistente continua siendo una de las principales molestias manifestadas por los pacientes después del RTR (5-10%), 2 por lo que la resuperficialización de la rótula se ha propuesto como una estrategia para tratar esta complicación. 3,4 La resuperficialización de la rótula durante un RTR sigue siendo un motivo de discrepancia entre los cirujanos, las tasas de uso oscilan entre el 2% y el 90%. 5,6 La decisión de resuperficializar o no la rótula se ha dejado principalmente en manos del cirujano, ya que la evidencia comunicada no es contundente respecto a su impacto en los resultados funcionales y las tasas de revisión.…”

Section: Introductionunclassified

“…5,6 La decisión de resuperficializar o no la rótula se ha dejado principalmente en manos del cirujano, ya que la evidencia comunicada no es contundente respecto a su impacto en los resultados funcionales y las tasas de revisión. 3,5 Por ejemplo, en el metanálisis de Longo y cols., se hallaron mejores puntuaciones en las escalas funcionales, así como una tasa de revisión más baja en pacientes sometidos a un RTR con resuperficialización de la rótula. 7 En cambio, autores, como Grassi y cols., han publicado resultados funcionales comparables entre los grupos.…”

Section: Introductionunclassified

Resuperficialización de la rótula en el reemplazo primario total de rodilla: estudio comparativo a dos años de seguimiento

Martínez

Ron-Translateur

Cantor

et al. 2021

Rev. Asoc. Arg. Ort. y Traumatol

View full text Add to dashboard Cite

Objetivo: Comparar los resultados funcionales del reemplazo total de rodilla con resuperficialización de rótula o sin resuperficialización, con dos años de seguimiento. Materiales y Métodos: Estudio observacional retrospectivo de grupos comparativos de pacientes con osteoartritis sometidos a un reemplazo total de rodilla primario con resuperficialización de rótula o sin este procedimiento, entre enero de 2014 y diciembre de 2016, dos centros de Colombia. A todos se les colocó una prótesis cementada Optetrak®. La función se evaluó previo cirugía y a los dos años mediante las escalas Knee Society Score (KSS), Hospital for Special Surgery (HSS) y Oxford Knee Score (OKS). Resultados: Se incluyeron 206 reemplazos totales de rodilla: 94 (grupo con resuperficialización) y 112 (grupo sin resuperficialización). La media de la edad en la cohorte de estudio era de 66.9 ± 9.7 años y el 76,7% (n = 155) eran mujeres. El tiempo quirúrgico fue más prolongado en el grupo con resuperficialización (mediana 100 min, RIC 90-110) que en el otro grupo (mediana 85 min, RIC 70-90; p <0,001). Aunque se observó una mejoría funcional antes del reemplazo total de rodilla y después, en ambos grupos, el cambio en el KSS clínico, el KSS funcional y el OKS fue mejor en el grupo con resuperficialización (p <0,05). Conclusiones: La resuperficialización de rótula durante el reemplazo total de rodilla se asoció a mejores resultados funcionales a los dos años. No obstante, los pacientes sin resuperficialización también refirieron una mejoría funcional después del reemplazo total de rodilla.Nivel de Evidencia: III

show abstract

Controversial Topics in Total Knee Arthroplasty: A 5-Year Update (Part 1)

Cited by 9 publications

References 36 publications

Anterior knee pain and sit-up tests predicts patients’ satisfaction and improvement in quality of life after anterior stabilized total knee replacement without patellar resurfacing

Anterior knee pain and sit-up tests predicts patients’ satisfaction and improvement in quality of life after anterior stabilized total knee replacement without patellar resurfacing

Range of Motion Comparison Following Total Knee Arthroplasty with and without Patella Resurfacing

Resuperficialización de la rótula en el reemplazo primario total de rodilla: estudio comparativo a dos años de seguimiento

Contact Info

Product

Resources

About