Does the degree of intraoperatively identified cartilage loss affect the outcomes of primary total knee arthroplasty without patella resurfacing? A prospective comparative cohort study

Abstract

Purpose The aim of this study was to investigate whether the degree of patellar cartilage loss confirmed during index surgery affects the clinical and radiologic outcomes of total knee arthroplasty (TKA) performed without patellar resurfacing. Methods We prospectively divided 2012 patients with a minimum follow-up of 12 months into two groups according to intraoperatively graded cartilage lesions graded using the International Cartilage Repair Society (ICRS) system: group 1, grades 0‒2 (n = 110); group 2, grades 3‒4 (n = 102). Relevant locations, such as medial, lateral, or both facets of the patella, were also assessed. Clinical outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index, Feller’s patella score, and Kujala anterior knee pain score. Radiographic outcomes included patellar tilt angle and lateral patellar shift on Merchant’s view. Results Clinical and radiographic outcomes were not significantly different between the two groups. No patient underwent secondary patellar resurfacing. Although the lateral facet was significantly more involved, there were no significant differences in outcomes. Conclusions The degree of intraoperatively identified patellar cartilage loss did not affect the short-term outcomes following primary TKA without patellar resurfacing. Level of evidence II: Prospective comparative study.

Preoperative patellar bone marrow lesions with full thickness cartilage defects correlate with residual anterior knee pain in total knee arthroplasty without patellar resurfacing

“…Holland et al [10] reported that there was no difference in the Oxford Knee Score, AKP, and Kujala AKPS between patients with and without patellar cartilage loss after TKA without patellar resurfacing. Park et al [23] and Shon et al [33] found that the visual assessment of cartilage according to the ICRS grade was not significantly associated with clinical outcomes and AKP. Our results are consistent with previous research showing that postoperative AKP cannot be predicted by the degree of cartilage defects alone.…”

The Effect of Severe Varus Deformity on Clinical and Radiographic Outcomes in Mechanical Aligned Total Knee Arthroplasty with Medial Stabilizing Technique

“…Varus and valgus were designated as positive and negative HKA angles, respectively [ 16 ]. Additionally, the lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) were assessed to examine the preoperative phenotype and implant position in the coronal plane [ 17 , 18 ]. The LDFA was defined as the angle between the line parallel to the femoral condyle and the mechanical axis of the femur.…”

Effect of mediolateral gap difference on postoperative outcomes in navigation-assisted total knee arthroplasty using an ultracongruent insert and the medial stabilising technique

“…The HKA angle was defined as the angle subtended by a line drawn from the centre of the femoral head to that of the knee and a line drawn from the centre of the knee to that of the talus on whole‐leg standing radiographs; positive and negative HKA angles indicate varus and valgus, respectively [26]. The lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) were measured to investigate the preoperative phenotype and implant positioning in the coronal plane [27, 32]. The LDFA angle was defined as the lateral angle between the line parallel to the femoral condyle and mechanical axis of the femur.…”