2015 ISAKOS Biennial Congress ePoster #1418

Short-Term Results of Patella Non-Resurfacing in Total Knee Arthroplasty - Comparison with Postoperative Patella Sclerotic Change

Kazuhiro Uenaka, MD, PhD, Otsu, Shiga JAPAN
Mitsuhiko Kubo, MD, PhD, Otsu, Shiga JAPAN
Hitomi Fujikawa, Otsu, Shiga JAPAN
Yoshitaka Matsusue, MD, Fushimi-ku, Kyoto JAPAN
Shiga University of Medical Science , Otsu, Shiga, JAPAN

FDA Status Not Applicable

Summary: We evaluated the short-term clinical results at one year after surgery in non-resurfacing TKA. There were 25 knees of bone sclerotic change in the patella axis at one year after surgery, with a significant difference in the age, HSSPS, and PFA. Clinical outcome was significantly lower in cases of patella sclerotic change. The Age, PFA has been implicated as risks of patella sclerotic change.

Abstract:

Purpose

Whether or not to perform the patella replacement in total knee arthroplasty (TKA) is controversial. We have performed to selective patellar resurfacing by the degree of patellar cartilage degeneration, and investigated short-term clinical outcome after non-resurfacing TKA focusing on the presence of postoperative patella sclerosis.

MATERIALS & METHODS
We operated non-resurfacing TKA, 74 knees of 70 cases from January 2011, to September 2013(18 males and 52 females, mean age 75.3). Using the Smith & Nephew Inc. LEGION, and Genesis II, patella were replaced over three degree of outerbridge classification. We investigated clinical outcomes and the X-ray evaluation for non-resurfacing group at one year after surgery. Clinical results were evaluated the Japanese Orthopaedic Association (JOA) score, Hospital for special surgery patella score (HSSPS), range of motion, satisfaction (%). Osteosclerosis image was evaluated patellar facet angle (PFA) in the X-ray of patella axis. The mean follow-up period was 14.3 months.

Results

The JOA score showed a significantly improved from the average preoperative point 59 to the postoperative points 75.3. There were 25 knees in the patella sclerotic change. We divided into two groups by the presence or absence of sclerotic change (sclerotic group SC, non-sclerotic group NSC), and evaluated. There was a significant difference between SC and NSC for HSSPS and the mean age, 79.4 and 90.9 points, 78.4 and 73.4-year-old respectively. Furthermore, there was a significant difference in PFA, 128.2 ° in SC and 134.9 ° in NSC. There was no significant difference, JOA score, postoperative range of motion, and the satisfaction.

Discussion

We evaluated the short-term clinical results at one year after surgery in non-resurfacing TKA. There were 25 knees of bone sclerotic change in the patella axis at one year after surgery, with a significant difference in the age, HSSPS, and PFA. Clinical outcome was significantly lower in cases of patella sclerotic change. The Age and PFA has been implicated as risks of patella sclerotic change. Future, it is necessary to examine the long-term results.