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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2017

13.09.2016 | Knee

The need for secondary resurfacing is affected by trochlear height in total knee arthroplasty

verfasst von: Lucas Werth, Mo Saffarini, Felix Amsler, Ashraf Abdelkafy, Michael T. Hirschmann

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 12/2017

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Abstract

Purpose

The purpose of the study was to compare the rate of secondary resurfacing in a consecutive series of five different total knee arthroplasty (TKA) systems. It was our hypothesis that different TKA design features such as sulcus angle or trochlear height influence the rate of secondary resurfacing.

Methods

A retrospective study was performed on data from patients who underwent TKA without primary patellar resurfacing from 2004 to 2012 in an university-affiliated hospital. The study cohort included 784 TKA patients (m:f = 302:482, mean age at surgery ± SD 71 ± 10). Five different cruciate-retaining TKA systems were used consecutively (Group A, Triathlon, Stryker, Switzerland (n = 296), Group B, PFC Sigma, DepuySynthes, Switzerland (n = 215), Group C, LCS, DepuySynthes, Switzerland (n = 81), Group D, Balansys, Mathys, Switzerland (n = 128), Group E, Duracon, Stryker, Switzerland (n = 64)). Data were retrospectively obtained from hospital archives. Patients demographics, age at surgery, type of TKA were noted. In addition, TKA component position was assessed on radiographs with respect to “The knee society total knee arthroplasty roentgenographic evaluation and scoring system” (TKA-RESS). Pearson Chi-square test was used to compare differences between groups (p < 0.05). There were no significant differences between the groups in terms of age, gender, and radiological outcomes.

Results

Twenty-six of 784 patients (3.3 %) underwent secondary resurfacing due to patellofemoral pain. In group A 4/296 patients (1.4 %), in group B 15/215 patients (7 %), in group C 5/81 patients (6.2 %), in group D 1/128 patients (0.8 %), in group E 1/64 patients (1.6 %) underwent secondary patellar resurfacing during follow-up. Significantly higher rates of secondary patellar resurfacing were seen in groups B and C when compared to the others (p < 0.001). It was found that the trochlear height in these TKA was higher than in the others.

Conclusions

Based on the findings of this study, trochlear height influences the need for secondary patellar resurfacing. The resurfacing rate ranged from 1 to 7 %, with the highest rate in the PFC Sigma TKA.

Level of evidence

Therapeutic study, Level III.
Literatur
1.
Zurück zum Zitat Burnett RSJ, Boone JL, Rosenzweig SD, Steger-May K, Barrack RL (2009) Patellar resurfacing compared with nonresurfacing in total knee arthroplasty. A concise follow-up of a randomized trial. J Bone Joint Surg Am 91:2562–2567CrossRefPubMed Burnett RSJ, Boone JL, Rosenzweig SD, Steger-May K, Barrack RL (2009) Patellar resurfacing compared with nonresurfacing in total knee arthroplasty. A concise follow-up of a randomized trial. J Bone Joint Surg Am 91:2562–2567CrossRefPubMed
2.
Zurück zum Zitat Chen K, Li G, Fu D, Yuan C, Zhang Q, Cai Z (2013) Patellar resurfacing versus nonresurfacing in total knee arthroplasty: a meta-analysis of randomised controlled trials. Int Orthop 37:1075–1083CrossRefPubMedPubMedCentral Chen K, Li G, Fu D, Yuan C, Zhang Q, Cai Z (2013) Patellar resurfacing versus nonresurfacing in total knee arthroplasty: a meta-analysis of randomised controlled trials. Int Orthop 37:1075–1083CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat D’Lima DD, Chen PC, Kester MA, Colwell CW (2003) Impact of patellofemoral design on patellofemoral forces and polyethylene stresses. J Bone Joint Surg Am 85(Suppl 4):85–93CrossRefPubMed D’Lima DD, Chen PC, Kester MA, Colwell CW (2003) Impact of patellofemoral design on patellofemoral forces and polyethylene stresses. J Bone Joint Surg Am 85(Suppl 4):85–93CrossRefPubMed
4.
Zurück zum Zitat Daniilidis K, Vogt B, Gosheger G, Henrichs M, Dieckmann R, Schulz D, Hoell S (2012) Patellar resurfacing as a second stage procedure for persistent anterior knee pain after primary total knee arthroplasty. Int Orthop 36:1181–1183CrossRefPubMedPubMedCentral Daniilidis K, Vogt B, Gosheger G, Henrichs M, Dieckmann R, Schulz D, Hoell S (2012) Patellar resurfacing as a second stage procedure for persistent anterior knee pain after primary total knee arthroplasty. Int Orthop 36:1181–1183CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Dejour D, Ntagiopoulos PG, Saffarini M (2014) Evidence of trochlear dysplasia in femoral component designs. Knee Surg Sports Traumatol Arthrosc 22:2599–2607CrossRefPubMed Dejour D, Ntagiopoulos PG, Saffarini M (2014) Evidence of trochlear dysplasia in femoral component designs. Knee Surg Sports Traumatol Arthrosc 22:2599–2607CrossRefPubMed
6.
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
7.
Zurück zum Zitat Grelsamer RP, Bazos AN, Proctor CS (1993) Radiographic analysis of patellar tilt. J Bone Joint Surg Br 75:822–824PubMed Grelsamer RP, Bazos AN, Proctor CS (1993) Radiographic analysis of patellar tilt. J Bone Joint Surg Br 75:822–824PubMed
8.
Zurück zum Zitat Helmy N, Anglin C, Greidanus NV, Masri BA (2008) To resurface or not to resurface the patella in total knee arthroplasty. Clin Orthop Relat Res 466:2775–2783CrossRefPubMedPubMedCentral Helmy N, Anglin C, Greidanus NV, Masri BA (2008) To resurface or not to resurface the patella in total knee arthroplasty. Clin Orthop Relat Res 466:2775–2783CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Indelli PF, Marcucci M, Cariello D, Poli P, Innocenti M (2012) Contemporary femoral designs in total knee arthroplasty: effects on the patello-femoral congruence. Int Orthop 36:1167–1173CrossRefPubMed Indelli PF, Marcucci M, Cariello D, Poli P, Innocenti M (2012) Contemporary femoral designs in total knee arthroplasty: effects on the patello-femoral congruence. Int Orthop 36:1167–1173CrossRefPubMed
10.
Zurück zum Zitat Kulkarni SK, Freeman MAR, Poal-Manresa JC, Asencio JI, Rodriguez JJ (2000) The patellofemoral joint in total knee arthroplasty. J Arthroplasty 15:424–429CrossRefPubMed Kulkarni SK, Freeman MAR, Poal-Manresa JC, Asencio JI, Rodriguez JJ (2000) The patellofemoral joint in total knee arthroplasty. J Arthroplasty 15:424–429CrossRefPubMed
11.
Zurück zum Zitat Lustig S, Magnussen RA, Dahm DL, Parker D (2012) Patellofemoral arthroplasty, where are we today? Knee Surg Sports Traumatol Arthrosc 20:1216–1226CrossRefPubMed Lustig S, Magnussen RA, Dahm DL, Parker D (2012) Patellofemoral arthroplasty, where are we today? Knee Surg Sports Traumatol Arthrosc 20:1216–1226CrossRefPubMed
12.
Zurück zum Zitat Lygre SHL, Espehaug B, Havelin LI, Vollset SE, Furnes O (2010) Does patella resurfacing really matter? Pain and function in 972 patients after primary total knee arthroplasty. Acta Orthop 81:99–107CrossRefPubMed Lygre SHL, Espehaug B, Havelin LI, Vollset SE, Furnes O (2010) Does patella resurfacing really matter? Pain and function in 972 patients after primary total knee arthroplasty. Acta Orthop 81:99–107CrossRefPubMed
13.
Zurück zum Zitat Mugnai R, Digennaro V, Ensini A, Leardini A, Catani F (2014) Can TKA design affect the clinical outcome? comparison between two guided-motion systems. Knee Surg Sports Traumatol Arthrosc 22:581–589CrossRefPubMed Mugnai R, Digennaro V, Ensini A, Leardini A, Catani F (2014) Can TKA design affect the clinical outcome? comparison between two guided-motion systems. Knee Surg Sports Traumatol Arthrosc 22:581–589CrossRefPubMed
14.
Zurück zum Zitat Parvizi J, Mortazavi SMJ, Devulapalli C, Hozack WJ, Sharkey PF, Rothman RH (2012) Secondary resurfacing of the patella after primary total knee arthroplasty does the anterior knee pain resolve? J Arthroplasty 27:21–26CrossRefPubMed Parvizi J, Mortazavi SMJ, Devulapalli C, Hozack WJ, Sharkey PF, Rothman RH (2012) Secondary resurfacing of the patella after primary total knee arthroplasty does the anterior knee pain resolve? J Arthroplasty 27:21–26CrossRefPubMed
15.
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 93:1301–1309CrossRefPubMed 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 93:1301–1309CrossRefPubMed
16.
Zurück zum Zitat Saffarini M, Ntagiopoulos PG, Demey G, Le Negaret B, Dejour DH (2014) Evidence of trochlear dysplasia in patellofemoral arthroplasty designs. Knee Surg Sports Traumatol Arthrosc 22:2574–2581CrossRefPubMed Saffarini M, Ntagiopoulos PG, Demey G, Le Negaret B, Dejour DH (2014) Evidence of trochlear dysplasia in patellofemoral arthroplasty designs. Knee Surg Sports Traumatol Arthrosc 22:2574–2581CrossRefPubMed
17.
Zurück zum Zitat Scheurer P, Reininga IHF, van Jonbergen H-PW, van Raay JJAM (2015) Secondary patellar resurfacing following total knee arthroplasty: a cohort study in fifty eight knees with a mean follow-up of thirty one months. Int Orthop 39:1301–1306CrossRefPubMed Scheurer P, Reininga IHF, van Jonbergen H-PW, van Raay JJAM (2015) Secondary patellar resurfacing following total knee arthroplasty: a cohort study in fifty eight knees with a mean follow-up of thirty one months. Int Orthop 39:1301–1306CrossRefPubMed
18.
Zurück zum Zitat Schindler OS (2012) The controversy of patellar resurfacing in total knee arthroplasty: ibisne in medio tutissimus? Knee Surg Sports Traumatol Arthrosc 20:1227–1244CrossRefPubMedPubMedCentral Schindler OS (2012) The controversy of patellar resurfacing in total knee arthroplasty: ibisne in medio tutissimus? Knee Surg Sports Traumatol Arthrosc 20:1227–1244CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Swan JD, Stoney JD, Lim K, Dowsey MM, Choong PFM (2010) The need for patellar resurfacing in total knee arthroplasty: a literature review. ANZ J Surg 80:223–233CrossRefPubMed Swan JD, Stoney JD, Lim K, Dowsey MM, Choong PFM (2010) The need for patellar resurfacing in total knee arthroplasty: a literature review. ANZ J Surg 80:223–233CrossRefPubMed
20.
Zurück zum Zitat Takahashi A, Sano H, Ohnuma M, Kashiwaba M, Chiba D, Kamimura M, Sugita T, Itoi E (2012) Patellar morphology and femoral component geometry influence patellofemoral contact stress in total knee arthroplasty without patellar resurfacing. Knee Surg Sports Traumatol Arthrosc 20:1787–1795CrossRefPubMed Takahashi A, Sano H, Ohnuma M, Kashiwaba M, Chiba D, Kamimura M, Sugita T, Itoi E (2012) Patellar morphology and femoral component geometry influence patellofemoral contact stress in total knee arthroplasty without patellar resurfacing. Knee Surg Sports Traumatol Arthrosc 20:1787–1795CrossRefPubMed
21.
Zurück zum Zitat Tanzer M, McLean CA, Laxer E, Casey J, Ahmed AM (2001) Effect of femoral component designs on the contact and tracking characteristics of the unresurfaced patella in total knee arthroplasty. Can J Surg 44:127–133PubMedPubMedCentral Tanzer M, McLean CA, Laxer E, Casey J, Ahmed AM (2001) Effect of femoral component designs on the contact and tracking characteristics of the unresurfaced patella in total knee arthroplasty. Can J Surg 44:127–133PubMedPubMedCentral
22.
Zurück zum Zitat Thévenin-Lemoine C, Ferrand M, Courvoisier A, Damsin J-P, Ducou le Pointe H, Vialle R (2011) Is the caton-deschamps index a valuable ratio to investigate patellar height in children? J Bone Joint Surg Am 93:e35CrossRefPubMed Thévenin-Lemoine C, Ferrand M, Courvoisier A, Damsin J-P, Ducou le Pointe H, Vialle R (2011) Is the caton-deschamps index a valuable ratio to investigate patellar height in children? J Bone Joint Surg Am 93:e35CrossRefPubMed
23.
Zurück zum Zitat Varadarajan KM, Rubash HE, Li G (2011) Are current total knee arthroplasty implants designed to restore normal trochlear groove anatomy? J Arthroplasty 26:274–281CrossRefPubMed Varadarajan KM, Rubash HE, Li G (2011) Are current total knee arthroplasty implants designed to restore normal trochlear groove anatomy? J Arthroplasty 26:274–281CrossRefPubMed
24.
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
The need for secondary resurfacing is affected by trochlear height in total knee arthroplasty
verfasst von
Lucas Werth
Mo Saffarini
Felix Amsler
Ashraf Abdelkafy
Michael T. Hirschmann
Publikationsdatum
13.09.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 12/2017
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4319-3

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