Skip to main content
Top
Published in: Archives of Orthopaedic and Trauma Surgery 8/2015

01-08-2015 | Knee Arthroplasty

Infrapatellar fat pad preservation reduces wound complications after minimally invasive total knee arthroplasty

Authors: Jai Gon Seo, Seung Ah Lee, Young-Wan Moon, Byung Hoon Lee, Young Hoo Ko, Moon Jong Chang

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 8/2015

Login to get access

Abstract

Introduction

The aim of this study was to determine whether pain intensity and wound complication rates differ between patients with and without preservation of the infrapatellar fat pad (IPFP) after minimally invasive total knee arthroplasty (TKA). The authors also sought to determine whether IPFP preservation affects operation time.

Materials and methods

This retrospective study included 448 knees with primary TKA. The IPFP was totally resected in 201 knees (IPFP-R group), and was preserved in 247 knees (IPFP-P group). Pain score was determined using the visual analog scale during the first 72 h after surgery. Wound complication rates and operation times were also evaluated. A wound complication was defined as persistent wound drainage for three or more days after surgery.

Results

There was no difference in pain levels between the two groups. However, there were fewer wound complications in the IPFP-P group (3 %) than in the IPFP-R group (13 %). The operation time was longer in the IPFP-P group than in the IPFP-R group (70 vs. 64 min, respectively).

Conclusions

Although IPFP preservation delayed operation time, it decreased wound complications after MIS TKA. These findings are important to consider when deciding whether or not to resect the IPFP. Whenever possible, IPFP preservation is probably the preferred technique to reduce wound complications.
Literature
2.
go back to reference Bos PK (2014) CORR Insights (R): the effect of infrapatellar fat pad excision on complications after minimally invasive TKA: a randomized controlled trial. Clin Orthop Relat Res 472:702–703PubMedCentralPubMedCrossRef Bos PK (2014) CORR Insights (R): the effect of infrapatellar fat pad excision on complications after minimally invasive TKA: a randomized controlled trial. Clin Orthop Relat Res 472:702–703PubMedCentralPubMedCrossRef
3.
go back to reference Dayton MR, Bade MJ, Muratore T, Shulman BC, Kohrt WM, Stevens-Lapsley JE (2013) Minimally invasive total knee arthroplasty: surgical implications for recovery. J Knee Surg 26:195–201PubMedCentralPubMedCrossRef Dayton MR, Bade MJ, Muratore T, Shulman BC, Kohrt WM, Stevens-Lapsley JE (2013) Minimally invasive total knee arthroplasty: surgical implications for recovery. J Knee Surg 26:195–201PubMedCentralPubMedCrossRef
4.
go back to reference Dennis DA (1997) Wound complications in total knee arthroplasty. Orthopedics 20:837–840PubMed Dennis DA (1997) Wound complications in total knee arthroplasty. Orthopedics 20:837–840PubMed
5.
go back to reference Frosch P, Decking J, Theis C, Drees P, Schoellner C, Eckardt A (2004) Complications after total knee arthroplasty: a comprehensive report. Acta Orthop Belg 70:565–569PubMed Frosch P, Decking J, Theis C, Drees P, Schoellner C, Eckardt A (2004) Complications after total knee arthroplasty: a comprehensive report. Acta Orthop Belg 70:565–569PubMed
6.
go back to reference Jackson G, Waldman BJ, Schaftel EA (2008) Complications following quadriceps-sparing total knee arthroplasty. Orthopedics 31:547PubMed Jackson G, Waldman BJ, Schaftel EA (2008) Complications following quadriceps-sparing total knee arthroplasty. Orthopedics 31:547PubMed
7.
go back to reference Kayler DE, Lyttle D (1988) Surgical interruption of patellar blood supply by total knee arthroplasty. Clin Orthop Relat Res 229:221–227PubMed Kayler DE, Lyttle D (1988) Surgical interruption of patellar blood supply by total knee arthroplasty. Clin Orthop Relat Res 229:221–227PubMed
8.
go back to reference Lehner B, Koeck FX, Capellino S, Schubert TE, Hofbauer R, Straub RH (2008) Preponderance of sensory versus sympathetic nerve fibers and increased cellularity in the infrapatellar fat pad in anterior knee pain patients after primary arthroplasty. J Orthop Res 26:342–350PubMedCrossRef Lehner B, Koeck FX, Capellino S, Schubert TE, Hofbauer R, Straub RH (2008) Preponderance of sensory versus sympathetic nerve fibers and increased cellularity in the infrapatellar fat pad in anterior knee pain patients after primary arthroplasty. J Orthop Res 26:342–350PubMedCrossRef
9.
go back to reference Lemon M, Packham I, Narang K, Craig DM (2007) Patellar tendon length after knee arthroplasty with and without preservation of the infrapatellar fat pad. J Arthroplasty 22:574–580PubMedCrossRef Lemon M, Packham I, Narang K, Craig DM (2007) Patellar tendon length after knee arthroplasty with and without preservation of the infrapatellar fat pad. J Arthroplasty 22:574–580PubMedCrossRef
10.
go back to reference Macule F, Sastre S, Lasurt S, Sala P, Segur JM, Mallofre C (2005) Hoffa’s fat pad resection in total knee arthroplasty. Acta Orthop Belg 71:714–717PubMed Macule F, Sastre S, Lasurt S, Sala P, Segur JM, Mallofre C (2005) Hoffa’s fat pad resection in total knee arthroplasty. Acta Orthop Belg 71:714–717PubMed
11.
go back to reference Meneghini RM, Pierson JL, Bagsby D, Berend ME, Ritter MA, Meding JB (2007) The effect of retropatellar fat pad excision on patellar tendon contracture and functional outcomes after total knee arthroplasty. J Arthroplasty 22:47–50PubMedCrossRef Meneghini RM, Pierson JL, Bagsby D, Berend ME, Ritter MA, Meding JB (2007) The effect of retropatellar fat pad excision on patellar tendon contracture and functional outcomes after total knee arthroplasty. J Arthroplasty 22:47–50PubMedCrossRef
12.
go back to reference Moverley R, Williams D, Bardakos N, Field R (2014) Removal of the infrapatellar fat pad during total knee arthroplasty: does it affect patient outcomes? Int Orthop 38:2483–2487PubMedCrossRef Moverley R, Williams D, Bardakos N, Field R (2014) Removal of the infrapatellar fat pad during total knee arthroplasty: does it affect patient outcomes? Int Orthop 38:2483–2487PubMedCrossRef
13.
go back to reference Pawar U, Rao KN, Sundaram PS, Thilak J, Varghese J (2009) Scintigraphic assessment of patellar viability in total knee arthroplasty after lateral release. J Arthroplasty 24:636–640PubMedCrossRef Pawar U, Rao KN, Sundaram PS, Thilak J, Varghese J (2009) Scintigraphic assessment of patellar viability in total knee arthroplasty after lateral release. J Arthroplasty 24:636–640PubMedCrossRef
14.
go back to reference Pinsornsak P, Naratrikun K, Chumchuen S (2014) The effect of infrapatellar fat pad excision on complications after minimally invasive TKA: a randomized controlled trial. Clin Orthop Relat Res 472:695–701PubMedCentralPubMedCrossRef Pinsornsak P, Naratrikun K, Chumchuen S (2014) The effect of infrapatellar fat pad excision on complications after minimally invasive TKA: a randomized controlled trial. Clin Orthop Relat Res 472:695–701PubMedCentralPubMedCrossRef
15.
go back to reference Shim SS, Leung G (1986) Blood supply of the knee joint. A microangiographic study in children and adults. Clin Orthop Relat Res 208:119–125PubMed Shim SS, Leung G (1986) Blood supply of the knee joint. A microangiographic study in children and adults. Clin Orthop Relat Res 208:119–125PubMed
16.
go back to reference Tanaka N, Sakahashi H, Sato E, Hirose K, Isima T (2003) Influence of the infrapatellar fat pad resection in a synovectomy during total knee arthroplasty in patients with rheumatoid arthritis. J Arthroplasty 18:897–902PubMedCrossRef Tanaka N, Sakahashi H, Sato E, Hirose K, Isima T (2003) Influence of the infrapatellar fat pad resection in a synovectomy during total knee arthroplasty in patients with rheumatoid arthritis. J Arthroplasty 18:897–902PubMedCrossRef
17.
go back to reference Van Beeck A, Clockaerts S, Somville J, Van Heeswijk JH, Van Glabbeek F, Bos PK, Reijman M (2013) Does infrapatellar fat pad resection in total knee arthroplasty impair clinical outcome? A systematic review. Knee 20:226–231PubMedCrossRef Van Beeck A, Clockaerts S, Somville J, Van Heeswijk JH, Van Glabbeek F, Bos PK, Reijman M (2013) Does infrapatellar fat pad resection in total knee arthroplasty impair clinical outcome? A systematic review. Knee 20:226–231PubMedCrossRef
Metadata
Title
Infrapatellar fat pad preservation reduces wound complications after minimally invasive total knee arthroplasty
Authors
Jai Gon Seo
Seung Ah Lee
Young-Wan Moon
Byung Hoon Lee
Young Hoo Ko
Moon Jong Chang
Publication date
01-08-2015
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 8/2015
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-015-2233-7

Other articles of this Issue 8/2015

Archives of Orthopaedic and Trauma Surgery 8/2015 Go to the issue