Publication: Resurfacing in a Posterior-Stabilized Total Knee Arthroplasty Reduces Patellar Crepitus Complication: A Randomized, Controlled Trial
Issued Date
2019-09-01
Resource Type
ISSN
15328406
08835403
08835403
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2-s2.0-85065824116
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Arthroplasty. Vol.34, No.9 (2019), 1969-1974
Suggested Citation
Satit Thiengwittayaporn, Kakanand Srungboonmee, Bhakawat Chiamtrakool Resurfacing in a Posterior-Stabilized Total Knee Arthroplasty Reduces Patellar Crepitus Complication: A Randomized, Controlled Trial. Journal of Arthroplasty. Vol.34, No.9 (2019), 1969-1974. doi:10.1016/j.arth.2019.04.050 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51430
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Title
Resurfacing in a Posterior-Stabilized Total Knee Arthroplasty Reduces Patellar Crepitus Complication: A Randomized, Controlled Trial
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Abstract
© 2019 Elsevier Inc. Background: Patellar crepitus (PC) is a common complication after total knee arthroplasty (TKA) using a posterior-stabilized (PS) prosthesis. While numerous factors have been associated with PC development after PS-TKA, patellar resurfacing (PR) which directly impacts the patellofemoral joint kinematics has been underinvestigated. A prospective, randomized, controlled trial was conducted to (1) compare the PC incidence in PR and non-PR PS-TKA, (2) determine the time of PC presentation in PS-TKA, (3) identify radiographic parameters associated with PC, and (4) compare clinical outcomes of patients with and without PR. Methods: A total of 84 patients who underwent unilateral TKA using the Legion PS Total Knee System were randomized into PR group or non-PR group. PC incidence, time of PC presentation, radiographic parameters associated with PC development, and clinical outcomes were evaluated at 3 months, 6 months, 9 months, and 1 year postoperatively. Results: PC occurred significantly more in the non-PR group (23.1% vs 7.3%, P =.048). Time of PC presentation in both groups was not different. Anterior knee pain was found in 16.7% of crepitus patients, and none required any surgical procedure. The non-PR knees had significant decreases in patellar shift index, patellar displacement, Insall-Salvati ratio, and patellar component height and increase in change in posterior femoral offset. Oxford and patellar scores were significantly better in the PR group at 9 months and 1 year. Conclusion: Given higher PC incidence and several worse clinical outcomes in the non-PR, we recommend resurfacing during PS-TKA with this knee system to avoid PC development.