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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-02-2021 | KNEE

Patellar component size effects patellar tilt in total knee arthroplasty with patellar resurfacing

Authors: Léopold Joseph, Cécile Batailler, Julien Roger, John Swan, Elvire Servien, Sébastien Lustig

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2021

Abstract

Purpose

Patellar component positioning and patellofemoral kinematics are of great importance in total knee arthroplasty (TKA). The factors influencing patellar tilt are femoral rotation and lateral patellar release. However, the effect of patellar component size remains unknown. The aim of this study was to evaluate the intra-operative risk factors for patellar tilt, particularly the effect of the patellar component size. The hypothesis was that increasing the patellar component size would reduce the risk of patellar tilt.

Methods

878 primary TKAs with patellar resurfacing were included between January 2015 and October 2018. Analysis was performed at 1-year postoperatively on patients categorized into two groups: patellar tilt (PT) and no patellar tilt (NPT). A multivariate analysis was performed for the effect of patellar component size, femoral rotation, femoral overbuilding, patellar thickness and lateral release on patellar tilt risk. Secondary analysis was performed for any difference in clinical outcomes and revision rates between groups.

Results

Multivariate analysis showed that increasing the patellar component size decreased the risk of patellar tilt by 37% (p < 0.001). Placing the femoral component at 3° of external rotation decreased the risk of patellar tilt by 67% (p < 0.001). Secondary analysis showed better clinical outcomes in the NPT group, especially regarding global satisfaction, and KSS objective and subjective scores. The revision for any cause was less in the NPT group (p = 0.019). The cause for TKA revision was related to the patellar in 11% of cases in the NPT group and 65% in the PT group (p < 0.001).

Conclusion

Increased patellar component size and positioning the femoral component in external rotation decreases the risk of patellar tilt, improves clinical outcomes and decreases the rate of surgical revision.

Level of evidence

III.

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Title: Patellar component size effects patellar tilt in total knee arthroplasty with patellar resurfacing
Authors: Léopold Joseph
Cécile Batailler
Julien Roger
John Swan
Elvire Servien
Sébastien Lustig
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2021
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-020-05984-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Patellar component size effects patellar tilt in total knee arthroplasty with patellar resurfacing

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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