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Patellar resurfacing throughout TKA is protected in sufferers with skinny patellae

January 23, 2023

2 min learn

Supply/Disclosures

supply:

Wilson JM, et al. Resurfacing the skinny native patella: Is it protected? Introduced at: American Affiliation of Hip and Knee Surgeons Annual Assembly; Nov 3-6, 2022; Grapevine, Texas.

Disclosures:
Wilson experiences no related monetary disclosures and experiences receiving institutional analysis assist from DePuy Synthes, Stryker and Zimmer Biomet.


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GRAPEVINE, Texas — Sufferers with a skinny native patella who underwent patellar resurfacing throughout major whole knee arthroplasty had 98% survivorship freed from patellar revision at median 10-year follow-up, in line with a presenter.

On the American Affiliation of Hip and Knee Surgeons Annual Assembly, right here, Jacob M. Wilson, M.D., offered outcomes of a research he and his colleagues on the Mayo Clinic carried out to find out whether or not resurfacing a skinny patella is a protected apply throughout major TKA. The rationale for the research was the very fact insufficient native patella thickness has been cited as a motive to resurface the patella, he mentioned.

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“There was good survival and medical outcomes achieved in resurfacing the skinny native patella. That being mentioned, we had three nonoperative periprosthetic patella fractures and one aseptic failure with patellar clunk, and, subsequently, we really feel the necessity ought to really be weighed towards the identified threat of leaving the patella unresurfaced on this identified cohort,” Wilson mentioned. .

Measured patellar thickness

Wilson and his colleagues recognized 11,333 sufferers within the Mayo Clinic whole joint registry who underwent major TKA with patellar resurfacing from 2000 to 2010. Of these sufferers, 200 (2.7%) had a skinny patella that measured lower than or equal to 19-mm thick earlier than resection. These sufferers additionally had postresection patellar measurements out there.

Utilizing calipers, sufferers had their patellar thickness measured pre-resection and post-resection. The median thickness was 19 mm (vary 2 mm to 9 mm) and 12.5 mm (vary 10 mm to 17 mm), respectively, in line with the summary.

The designs of resurfaced patellae used had been cemented, all-polyethylene with a median diameter of 32 mm. As well as, 93% of the sufferers had been girls. The imply age was 69 years, and the BMI was 31 kg.m2Wilson mentioned.

“The ten-year survivorship freed from patellar-related problems was 96.5% at 10 years. We then particularly checked out survivorship freed from periprosthetic patellar fracture at 10 years and this was 98.9%,” Wilson mentioned.

Total, there have been seven patella-related problems within the cohort with three periprosthetic fractures, all of which occurred in feminine sufferers with an intact extensor mechanism and a well-fixed element. These sufferers underwent nonoperative administration, in line with Wilson. “[Patients had] a pre-resection thickness of 16 [mm] to 19 mm and post-resection thickness of 12 [mm] to 14 mm, however these fractures occurred in sufferers who weren’t overly skinny.”

As well as, researchers recognized one case of patellar aseptic loosening.

Knee Society Scores improved

“Concerning the medical outcomes, the preoperative Knee Society Rating (KSS) was low with a imply of 36. It did enhance considerably postoperatively at 2, 5 and 10 years. At 10 years, the imply KSS was 81,” Wilson mentioned.

The research obtained the AAHKS Surgical Strategies and Applied sciences Award, which acknowledges excellent surgical innovation developments in reconstructive surgical procedure.

“We had been honored to obtain the AAHKS Surgical Strategies and Applied sciences Award for our paper on resurfacing the skinny native patella. Sufferers with a skinny patella typically have vital patellofemoral arthritis, and prior information from our establishment discovered increased revision charges in related sufferers who had been left un-resurfaced. For that reason, we sought to find out whether or not resurfacing was protected on this affected person inhabitants. Our outcomes recommend that this can be a protected apply, and we hope these information will probably be helpful to surgeons when encountering this medical scenario,” Wilson mentioned in a press launch from AAHKS.

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