Cargando…
Resurfacing versus not-resurfacing the patella in one-stage bilateral total knee arthroplasty: a prospective randomized clinical trial
PURPOSE: Resurfacing the patella in one-stage bilateral total knee arthroplasty (TKA) remains debatable. This study aimed to assess the mid-term outcomes of patients after one-stage bilateral TKA performed with and without patellar resurfacing, respectively, with at least five years of follow-up. ME...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848038/ https://www.ncbi.nlm.nih.gov/pubmed/31227852 http://dx.doi.org/10.1007/s00264-019-04361-7 |
_version_ | 1783469006749958144 |
---|---|
author | Ha, Chengzhi Wang, Baoxin Li, Wei Sun, Kang Wang, Dawei Li, Qicai |
author_facet | Ha, Chengzhi Wang, Baoxin Li, Wei Sun, Kang Wang, Dawei Li, Qicai |
author_sort | Ha, Chengzhi |
collection | PubMed |
description | PURPOSE: Resurfacing the patella in one-stage bilateral total knee arthroplasty (TKA) remains debatable. This study aimed to assess the mid-term outcomes of patients after one-stage bilateral TKA performed with and without patellar resurfacing, respectively, with at least five years of follow-up. METHODS: Sixty-six patients (132 knees) scheduled for first-ever one-stage bilateral TKA due to osteoarthritis received patellar resurfacing and retention, respectively, on one knee and the other, randomly selected. All patients received Scorpio NRG knee prostheses and were evaluated by radiology (anteroposterior, lateral, and axial views) pre-operatively and yearly post-operatively, for at least five years. Knee Society Score and Feller Score values were measured. Anterior knee pain, patellar clunk, and patient satisfaction were assessed. RESULTS: One patient died within five years of operation and four were lost to follow-up. One patient developed severe dementia and could not be constructively questioned. Therefore, 60 patients (120 knees) were finally analyzed. There were significantly improved Knee Society and Feller scores (P < 0.001) in the resurfacing group compared with the non-resurfacing group post-operatively. Anterior knee pain and patellar clunk rates were lower on the resurfaced side compared with the non-resurfaced side (P < 0.001). Meanwhile, 47% and only 7% patients preferred the resurfaced and non-resurfaced sides, respectively, at final follow-up. No revision was performed for patellofemoral complications, and no significant differences were found between the two groups in radiographic outcomes. CONCLUSIONS: Using the Scorpio NRG knee prosthesis, patellar resurfacing is superior to non-resurfacing in patients with osteoarthritis observed for ≥ five years. REGISTRATION TRIALS NUMBER: NCT03600922 KEY POINTS: • Findings Patellar resurfacing is superior to non-resurfacing in osteoarthritis (OA) patients undergoing total knee arthroplasty (TKA) with the Scorpio NRG knee prosthesis. • Implications Patellar resurfacing should be performed in OA patients during TKA. • Caution Several prosthesis types should be assessed in the same study setting, and multicenter studies are required before generalizability of the present findings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00264-019-04361-7) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6848038 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-68480382019-11-22 Resurfacing versus not-resurfacing the patella in one-stage bilateral total knee arthroplasty: a prospective randomized clinical trial Ha, Chengzhi Wang, Baoxin Li, Wei Sun, Kang Wang, Dawei Li, Qicai Int Orthop Original Paper PURPOSE: Resurfacing the patella in one-stage bilateral total knee arthroplasty (TKA) remains debatable. This study aimed to assess the mid-term outcomes of patients after one-stage bilateral TKA performed with and without patellar resurfacing, respectively, with at least five years of follow-up. METHODS: Sixty-six patients (132 knees) scheduled for first-ever one-stage bilateral TKA due to osteoarthritis received patellar resurfacing and retention, respectively, on one knee and the other, randomly selected. All patients received Scorpio NRG knee prostheses and were evaluated by radiology (anteroposterior, lateral, and axial views) pre-operatively and yearly post-operatively, for at least five years. Knee Society Score and Feller Score values were measured. Anterior knee pain, patellar clunk, and patient satisfaction were assessed. RESULTS: One patient died within five years of operation and four were lost to follow-up. One patient developed severe dementia and could not be constructively questioned. Therefore, 60 patients (120 knees) were finally analyzed. There were significantly improved Knee Society and Feller scores (P < 0.001) in the resurfacing group compared with the non-resurfacing group post-operatively. Anterior knee pain and patellar clunk rates were lower on the resurfaced side compared with the non-resurfaced side (P < 0.001). Meanwhile, 47% and only 7% patients preferred the resurfaced and non-resurfaced sides, respectively, at final follow-up. No revision was performed for patellofemoral complications, and no significant differences were found between the two groups in radiographic outcomes. CONCLUSIONS: Using the Scorpio NRG knee prosthesis, patellar resurfacing is superior to non-resurfacing in patients with osteoarthritis observed for ≥ five years. REGISTRATION TRIALS NUMBER: NCT03600922 KEY POINTS: • Findings Patellar resurfacing is superior to non-resurfacing in osteoarthritis (OA) patients undergoing total knee arthroplasty (TKA) with the Scorpio NRG knee prosthesis. • Implications Patellar resurfacing should be performed in OA patients during TKA. • Caution Several prosthesis types should be assessed in the same study setting, and multicenter studies are required before generalizability of the present findings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00264-019-04361-7) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2019-06-21 2019-11 /pmc/articles/PMC6848038/ /pubmed/31227852 http://dx.doi.org/10.1007/s00264-019-04361-7 Text en © The Author(s) 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Paper Ha, Chengzhi Wang, Baoxin Li, Wei Sun, Kang Wang, Dawei Li, Qicai Resurfacing versus not-resurfacing the patella in one-stage bilateral total knee arthroplasty: a prospective randomized clinical trial |
title | Resurfacing versus not-resurfacing the patella in one-stage bilateral total knee arthroplasty: a prospective randomized clinical trial |
title_full | Resurfacing versus not-resurfacing the patella in one-stage bilateral total knee arthroplasty: a prospective randomized clinical trial |
title_fullStr | Resurfacing versus not-resurfacing the patella in one-stage bilateral total knee arthroplasty: a prospective randomized clinical trial |
title_full_unstemmed | Resurfacing versus not-resurfacing the patella in one-stage bilateral total knee arthroplasty: a prospective randomized clinical trial |
title_short | Resurfacing versus not-resurfacing the patella in one-stage bilateral total knee arthroplasty: a prospective randomized clinical trial |
title_sort | resurfacing versus not-resurfacing the patella in one-stage bilateral total knee arthroplasty: a prospective randomized clinical trial |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848038/ https://www.ncbi.nlm.nih.gov/pubmed/31227852 http://dx.doi.org/10.1007/s00264-019-04361-7 |
work_keys_str_mv | AT hachengzhi resurfacingversusnotresurfacingthepatellainonestagebilateraltotalkneearthroplastyaprospectiverandomizedclinicaltrial AT wangbaoxin resurfacingversusnotresurfacingthepatellainonestagebilateraltotalkneearthroplastyaprospectiverandomizedclinicaltrial AT liwei resurfacingversusnotresurfacingthepatellainonestagebilateraltotalkneearthroplastyaprospectiverandomizedclinicaltrial AT sunkang resurfacingversusnotresurfacingthepatellainonestagebilateraltotalkneearthroplastyaprospectiverandomizedclinicaltrial AT wangdawei resurfacingversusnotresurfacingthepatellainonestagebilateraltotalkneearthroplastyaprospectiverandomizedclinicaltrial AT liqicai resurfacingversusnotresurfacingthepatellainonestagebilateraltotalkneearthroplastyaprospectiverandomizedclinicaltrial |