Skip to main content
Erschienen in: International Orthopaedics 3/2018

07.10.2017 | Original Paper

Does the grading of chondromalacia patellae influence anterior knee pain following total knee arthroplasty without patellar resurfacing?

verfasst von: Guo-Chun Zha, Shuo Feng, Xiang-Yang Chen, Kai-Jin Guo

Erschienen in: International Orthopaedics | Ausgabe 3/2018

Einloggen, um Zugang zu erhalten

Abstract

Objectives

The influence of chondromalacia patellae (CMP) on post-operative anterior knee pain (AKP) following total knee arthroplasty (TKA) remains controversial, and few studies have focused on the relationship between them. The purpose of this study was to determine whether different CMP grades affect the incidence of AKP after TKA without patellar resurfacing.

Methods

We performed a retrospective analysis of prospectively collected data on 290 TKAs with the use of the low contact stress mobile-bearing prosthesis, without patellar resurfacing in 290 patients from February 2009 to January 2013. Patients were assessed by the Outerbridge classification for CMP, visual analog scale for AKP, the Knee Society clinical scoring system of knee score (KS), function score (FS), the patellar score (PS) for clinical function, and patients’ satisfaction.

Results

The intra-operative grading of CMP: grade I in 30 patients, grade II in 68 patients, grade III in 97 patients, and grade IV in 95 patients. The incidence of AKP at 36-month follow-up was 10.3% (30/290). No statistical difference was detected among the different CMP grades in terms of the incidence of AKP (p = 0.995), patients’ satisfaction (p = 0.832), KS (p = 0.228), FS (p = 0.713), and PS (p = 0.119) at 36-month follow-up.

Conclusions

The findings may suggest no relevant influence of CMP grading on the incidence of AKP after TKA without patellar resurfacing.
Literatur
1.
Zurück zum Zitat Altay MA, Ertürk C, Altay N, Akmeşe R, Işıkan UE (2012) Patellar denervation in total knee arthroplasty without patellar resurfacing: a prospective, randomized controlled study. Orthop Traumatol Surg Res 98(4):421–425CrossRefPubMed Altay MA, Ertürk C, Altay N, Akmeşe R, Işıkan UE (2012) Patellar denervation in total knee arthroplasty without patellar resurfacing: a prospective, randomized controlled study. Orthop Traumatol Surg Res 98(4):421–425CrossRefPubMed
3.
Zurück zum Zitat Bindelglass DF, Cohen JL, Dorr LD (1993) Patellar tilt and subluxation in total knee arthroplasty. Relationship to pain, fixation, and design. Clin Orthop Relat Res 286:103–109 Bindelglass DF, Cohen JL, Dorr LD (1993) Patellar tilt and subluxation in total knee arthroplasty. Relationship to pain, fixation, and design. Clin Orthop Relat Res 286:103–109
4.
Zurück zum Zitat Boyd AD Jr, Ewald FC, Thomas WH, Poss R, Sledge CB (1993) Long-term complications after total knee arthroplasty with or without resurfacing of the patella. J Bone Joint Surg Am 75(5):674–681CrossRefPubMed Boyd AD Jr, Ewald FC, Thomas WH, Poss R, Sledge CB (1993) Long-term complications after total knee arthroplasty with or without resurfacing of the patella. J Bone Joint Surg Am 75(5):674–681CrossRefPubMed
5.
Zurück zum Zitat Breugem SJ, Sierevelt IN, Schafroth MU, Blankevoort L, Schaap GR, van Dijk CN (2008) Less anterior knee pain with a mobile-bearing prosthesis compared with a fixed-bearing prosthesis. Clin Orthop Relat Res 466(8):1959–1965CrossRefPubMedPubMedCentral Breugem SJ, Sierevelt IN, Schafroth MU, Blankevoort L, Schaap GR, van Dijk CN (2008) Less anterior knee pain with a mobile-bearing prosthesis compared with a fixed-bearing prosthesis. Clin Orthop Relat Res 466(8):1959–1965CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Busch CA, Shore BJ, Bhandari R, Ganapathy S, MacDonald SJ, Bourne RB, Rorabeck CH, McCalden RW (2006) Efficacy of periarticular multinndal drug injection in total knee arthroplasty. A randomized trial. J Bone Joint Surg Am 88(5):959–963CrossRefPubMed Busch CA, Shore BJ, Bhandari R, Ganapathy S, MacDonald SJ, Bourne RB, Rorabeck CH, McCalden RW (2006) Efficacy of periarticular multinndal drug injection in total knee arthroplasty. A randomized trial. J Bone Joint Surg Am 88(5):959–963CrossRefPubMed
7.
Zurück zum Zitat Enis JE, Gardner R, Robledo MA, Latta L, Smith R (1990) Comparison of patellar resurfacing versus nonresurfacing in bilateral total knee arthroplasty. Clin Orthop Relat Res 260:38–42 Enis JE, Gardner R, Robledo MA, Latta L, Smith R (1990) Comparison of patellar resurfacing versus nonresurfacing in bilateral total knee arthroplasty. Clin Orthop Relat Res 260:38–42
8.
Zurück zum Zitat Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12 Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12
9.
Zurück zum Zitat Feller JA, Baartllet RJ, Lang DM (1996) Patellar resurfacing versus retention in total knee arthroplasty. J Bone Joint Surg Br 78(2):226–228CrossRefPubMed Feller JA, Baartllet RJ, Lang DM (1996) Patellar resurfacing versus retention in total knee arthroplasty. J Bone Joint Surg Br 78(2):226–228CrossRefPubMed
10.
Zurück zum Zitat Gomes LS, Bechtold JE, Gustilo RB (1988) Patellar prosthesis positioning in total knee arthroplasty. A roentgenographic study. Clin Orthop Relat Res 236:72–81 Gomes LS, Bechtold JE, Gustilo RB (1988) Patellar prosthesis positioning in total knee arthroplasty. A roentgenographic study. Clin Orthop Relat Res 236:72–81
11.
Zurück zum Zitat Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14 Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14
12.
Zurück zum Zitat Kajino A, Yoshino S, Kameyama S, Kohda M, Nagashima S (1997) Comparison of the results of bilateral total knee arthroplasty with and without patellar replacement for rheumatoid arthritis. A follow-up note. J Bone Joint Surg Am 79(4):570–574CrossRefPubMed Kajino A, Yoshino S, Kameyama S, Kohda M, Nagashima S (1997) Comparison of the results of bilateral total knee arthroplasty with and without patellar replacement for rheumatoid arthritis. A follow-up note. J Bone Joint Surg Am 79(4):570–574CrossRefPubMed
13.
Zurück zum Zitat Kim BS, Reitman RD, Schai PA, Scott RD (1999) Selective patellar nonresurfacing in total knee arthroplasty. 10 year results. Clin Orthop Relat Res 367:81–88CrossRef Kim BS, Reitman RD, Schai PA, Scott RD (1999) Selective patellar nonresurfacing in total knee arthroplasty. 10 year results. Clin Orthop Relat Res 367:81–88CrossRef
14.
Zurück zum Zitat Kulkarni SK, Freeman MA, Poal-Manresa JC, Asencio JI, Rodriguez JJ (2000) The patellofemoral joint in total knee arthroplasty: is the design of the trochlea the critical factor? J Arthroplast 15(4):424–429CrossRef Kulkarni SK, Freeman MA, Poal-Manresa JC, Asencio JI, Rodriguez JJ (2000) The patellofemoral joint in total knee arthroplasty: is the design of the trochlea the critical factor? J Arthroplast 15(4):424–429CrossRef
15.
Zurück zum Zitat Maradit-Kremers H, Haque OJ, Kremers WK, Berry DJ, Lewallen DG, Trousdale RT, Sierra RJ (2017) Is selectively not resurfacing the patella an acceptable practice in primary total knee arthroplasty? J Arthroplast 32(4):1143–1147CrossRef Maradit-Kremers H, Haque OJ, Kremers WK, Berry DJ, Lewallen DG, Trousdale RT, Sierra RJ (2017) Is selectively not resurfacing the patella an acceptable practice in primary total knee arthroplasty? J Arthroplast 32(4):1143–1147CrossRef
17.
Zurück zum Zitat Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br 43:752–757CrossRefPubMed Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br 43:752–757CrossRefPubMed
18.
Zurück zum Zitat Pavlou G, Meyer C, Leonidou A, As-Sultany M, West R, Tsiridis E (2011) Patellar resurfacing in total knee arthroplasty: does design matter?: a meta-analysis of 7075 cases. J Bone Joint Surg Am 93(14):1301–1309CrossRefPubMed Pavlou G, Meyer C, Leonidou A, As-Sultany M, West R, Tsiridis E (2011) Patellar resurfacing in total knee arthroplasty: does design matter?: a meta-analysis of 7075 cases. J Bone Joint Surg Am 93(14):1301–1309CrossRefPubMed
19.
Zurück zum Zitat Peretz JI, Driftmier KR, Cerynik DL, Kumar NS, Johanson NA (2012) Does lateral release change patellofemoral forces and pressures?: a pilot study. Clin Orthop Relat Res 470(3):903–909CrossRefPubMed Peretz JI, Driftmier KR, Cerynik DL, Kumar NS, Johanson NA (2012) Does lateral release change patellofemoral forces and pressures?: a pilot study. Clin Orthop Relat Res 470(3):903–909CrossRefPubMed
20.
Zurück zum Zitat Picetti GD 3rd, McGann WA, Welch RB (1990) The patellofemoral joint after total knee arthroplasty without patellar resurfacing. J Bone Joint Surg Am 72(9):1379–1382CrossRefPubMed Picetti GD 3rd, McGann WA, Welch RB (1990) The patellofemoral joint after total knee arthroplasty without patellar resurfacing. J Bone Joint Surg Am 72(9):1379–1382CrossRefPubMed
21.
Zurück zum Zitat Rodríguez-Merchán EC, Gómez-Cardero P (2010) The outerbridge classification predicts the need for patellar resurfacing in TKA. Clin Orthop Relat Res 468(5):1254–1257CrossRefPubMed Rodríguez-Merchán EC, Gómez-Cardero P (2010) The outerbridge classification predicts the need for patellar resurfacing in TKA. Clin Orthop Relat Res 468(5):1254–1257CrossRefPubMed
22.
Zurück zum Zitat Schindler OS (2012) The controversy of patellar resurfacing in total knee arthroplasty: Ibisne in medio tutissimus? Knee Surg Sports Traumatol Arthrosc 20(7):1227–1244CrossRefPubMedPubMedCentral Schindler OS (2012) The controversy of patellar resurfacing in total knee arthroplasty: Ibisne in medio tutissimus? Knee Surg Sports Traumatol Arthrosc 20(7):1227–1244CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Swan JD, Stoney JD, Lim K, Dowsey MM, Choong PF (2010) The need for patellar resurfacing in total knee arthroplasty: a literature review. ANZ J Surg 80(4):223–233CrossRefPubMed Swan JD, Stoney JD, Lim K, Dowsey MM, Choong PF (2010) The need for patellar resurfacing in total knee arthroplasty: a literature review. ANZ J Surg 80(4):223–233CrossRefPubMed
24.
Zurück zum Zitat Theiss SM, Kitziger KJ, Lotke PS, Lotke PA (1996) Component design affecting patellofemoral complications after total knee replacement. Clin Orthop Relat Res 326:183–187CrossRef Theiss SM, Kitziger KJ, Lotke PS, Lotke PA (1996) Component design affecting patellofemoral complications after total knee replacement. Clin Orthop Relat Res 326:183–187CrossRef
25.
Zurück zum Zitat van Jonbergen HP, Scholtes VA, van Kampen A, Poolman RW (2011) A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing. J Bone Joint Surg Br 93(8):1054–1059CrossRefPubMed van Jonbergen HP, Scholtes VA, van Kampen A, Poolman RW (2011) A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing. J Bone Joint Surg Br 93(8):1054–1059CrossRefPubMed
26.
Zurück zum Zitat Waters TS, Bentley G (2003) Patellar resurfacing in total knee arthroplasty. A prospective, randomized study. J Bone Joint Surg Am 85(2):212–217CrossRefPubMed Waters TS, Bentley G (2003) Patellar resurfacing in total knee arthroplasty. A prospective, randomized study. J Bone Joint Surg Am 85(2):212–217CrossRefPubMed
27.
Zurück zum Zitat Whiteside LA, Nakamura T (2003) Effect of femoral component design on unresurfaced patellas in knee arthroplasty. Clin Orthop Relat Res 410:189–198CrossRef Whiteside LA, Nakamura T (2003) Effect of femoral component design on unresurfaced patellas in knee arthroplasty. Clin Orthop Relat Res 410:189–198CrossRef
Metadaten
Titel
Does the grading of chondromalacia patellae influence anterior knee pain following total knee arthroplasty without patellar resurfacing?
verfasst von
Guo-Chun Zha
Shuo Feng
Xiang-Yang Chen
Kai-Jin Guo
Publikationsdatum
07.10.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 3/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3658-0

Weitere Artikel der Ausgabe 3/2018

International Orthopaedics 3/2018 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.