New evidence on patella resurfacing in modern total knee arthroplasty for all inflammatory arthritis in a mixed Asian population

Q2 Medicine Journal of Clinical Orthopaedics and Trauma Pub Date : 2024-11-01 DOI:10.1016/j.jcot.2024.102798

Sherlyn Yen Yu Tham , Wu Chean Lee , Zavier Yongxuan Lim , Remesh Kunnasegaran

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Abstract

Background

Traditional teaching advocates for routine patella resurfacing (PR) during total knee arthroplasty (TKA) in patients with inflammatory arthritis. However, evidence on this topic remains limited in the Asian population. This study aims to evaluate the postoperative outcomes and complication of patella resurfacing (PR) during primary total knee arthroplasty (TKA) in Asian patients with inflammatory arthritis.

Methods

A retrospective analysis was conducted using registry data from our institution. Patients with inflammatory arthritis who underwent primary TKA from August 2017 to December 2021 were included in the study. Patients were divided into two groups - patella resurfaced (PR, n = 25) and non-resurfaced patella (PNR, n = 31) groups. Demographics, operative data, patient reported outcome measures, and complications were compared.

Results

Preoperative range of motion (ROM) (PR:95.3 ± 23.6° vs PNR:105 ± 19.5°, p = 0.106), Knee Society Scoring System Knee score (KS-KS) (PR:44.6 ± 17.4 vs PNR:49.3 ± 17.7, p = 0.331) and Knee Society Function Score (KS-FS) (PR:40.9 ± 27.3 vs PNR:47.7 ± 27.0, p = 0.325) and Oxford Knee Score (OKS) (PR:25.0 ± 7.8 vs PNR:23.3 ± 10.3, p = 0.525) were similar in both groups. Outcomes between PR and PNR groups at the one-year mark in terms of ROM (PR:112.7 ± 18.1 vs PNR:114.6 ± 16.5, p = 0.455), OKS (PR:41.5 ± 3.9 vs PNR:41 ± 4.7, p = 0.954), KS-KS (PR:84.5 ± 13.2 vs PNR:89.2 ± 9.3, p = 0.095) and KS-FS (PR:73.6 ± 18.3 vs PNR:78.7 ± 19.3, p = 0.173) were also similar. Intraoperative complication (PR:0/25 vs PNR: 3/31 (9.6 %), p = 0.245) and re-operation rates (PR: 1/25 (4 %) vs PNR: 1/31 (3.2 %), p = 0.877) were also similar in both groups.

Conclusion

This study conducted on a mixed Asian population with inflammatory arthritis demonstrated that the one-year postoperative ROM and functional outcomes, complication, and re-operation rates between PR and PNR groups were similar. Hence, routine patella resurfacing on all Asian patients with inflammatory arthritis undergoing TKA may not be necessary.

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现代全膝关节置换术治疗亚洲混血儿所有炎症性关节炎的髌骨复位新证据

背景传统教学主张炎症性关节炎患者在进行全膝关节置换术（TKA）时常规进行髌骨复位（PR）。然而，在亚洲人群中，这方面的证据仍然有限。本研究旨在评估亚洲炎症性关节炎患者在初级全膝关节置换术（TKA）中进行髌骨翻修（PR）的术后效果和并发症。研究纳入了2017年8月至2021年12月期间接受初级TKA手术的炎症性关节炎患者。患者分为两组--髌骨复位组（PR，n = 25）和非髌骨复位组（PNR，n = 31）。结果术前活动范围（ROM）（PR：95.3 ± 23.6° vs PNR：105 ± 19.5°，P = 0.106）、膝关节协会评分系统膝关节评分（KS-KS）（PR：44.6 ± 17.4 vs PNR:49.3 ± 17.7，p = 0.331）、膝关节社会功能评分（KS-FS）（PR:40.9 ± 27.3 vs PNR:47.7 ± 27.0，p = 0.325）和牛津膝关节评分（OKS）（PR:25.0 ± 7.8 vs PNR:23.3 ± 10.3，p = 0.525）在两组中相似。PR 组和 PNR 组在一年后的 ROM（PR:112.7 ± 18.1 vs PNR:114.6 ± 16.5，p = 0.455）、OKS（PR:41.5 ± 3.9 vs PNR:41 ± 4.7，p = 0.954）、KS-KS（PR：84.5 ± 13.2 vs PNR：89.2 ± 9.3，p = 0.095）和 KS-FS（PR：73.6 ± 18.3 vs PNR：78.7 ± 19.3，p = 0.173）也相似。两组的术中并发症（PR：0/25 vs PNR：3/31 (9.6%)，p = 0.245）和再次手术率（PR：1/25 (4 %) vs PNR：1/31 (3.2%)，p = 0.877）也相似。因此，对所有接受 TKA 的亚洲炎症性关节炎患者进行常规髌骨复位可能并无必要。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.