Do Changes in Patellofemoral Joint Offset Lead to Adverse Outcomes in Total Knee Arthroplasty With Patellar Resurfacing? A Radiographic Review

Patellofemoral joint biomechanics contribute to anterior knee pain, instability, and dysfunction following total knee arthroplasty (TKA). Information about specific factors leading to anterior knee pain and dysfunction is currently limited. Changes in patellofemoral joint offset (PFO) refers to a mi...

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Veröffentlicht in:The Journal of arthroplasty Jg. 32; H. 3; S. 783 - 787.e1
Hauptverfasser: Matz, Jacob, Howard, James L., Morden, David J., MacDonald, Steven J., Teeter, Matthew G., Lanting, Brent A.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Elsevier Inc 01.03.2017
Schlagworte:
Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee - adverse effects
Female
Femur - surgery
Humans
Knee - surgery
knee arthroplasty
Knee Joint - anatomy & histology
Knee Joint - surgery
Knee Prosthesis
Male
Orthopedics
Osteoarthritis - surgery
overstuffing
Pain - surgery
Pain Measurement
Patella - surgery
patellofemoral
Patellofemoral Joint - anatomy & histology
Patellofemoral Joint - surgery
patellofemoral offset
patient reported outcomes
Postoperative Period
Range of Motion, Articular
Retrospective Studies
Treatment Outcome
overstuffing
knee arthroplasty
patellofemoral
patient reported outcomes
patellofemoral offset
ISSN:0883-5403, 1532-8406, 1532-8406
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Zusammenfassung:Patellofemoral joint biomechanics contribute to anterior knee pain, instability, and dysfunction following total knee arthroplasty (TKA). Information about specific factors leading to anterior knee pain and dysfunction is currently limited. Changes in patellofemoral joint offset (PFO) refers to a mismatch between the preoperative and postoperative anteroposterior geometry of the patellofemoral joint. It remains unclear whether these changes lead to adverse outcomes in TKA. A retrospective radiographic review of 970 knees pre-TKA and post-TKA was completed to correlate the radiographic and clinical outcomes of changing the PFO using a posterior-stabilized single knee design with patellar resurfacing. A total of 970 patients were reviewed. Postoperatively, the anterior femoral offset, anteroposterior femoral size, and anterior patellar offset were changed in 40%, 60%, and 71% of knees, respectively, compared to preoperative values. The Western Ontario and McMasters Osteoarthritis Index total score as well as subscale scores for pain and function were not significantly affected by an increase or decrease in PFO. Similarly, Knee Society Scores and range of motion were not significantly affected. Increased anterior patellar offset was, however, associated with increased postoperative patellar tilt. Postoperative patellar tilt was not correlated with adverse patient satisfaction scores or loss of range of motion. Changes in PFO (decreased, maintained, or increased) are common post-TKA and are not associated with a difference in clinical outcomes. Increases in anterior patellar offset led to increased patellar tilt, which was not associated with adverse patient satisfaction scores.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0883-5403
1532-8406
1532-8406
DOI:10.1016/j.arth.2016.08.032