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When to Do Selective Patellar Resurfacing in Total Knee Arthroplasty: A Decision-Making Algorithm Based on Pre-operative and Intra-operative Findings.
Palanisamy, Yuvarajan; Naidu, Surya Prakash; Prasad, Arjun R; Natarajan, Sugumar; Rajan, David V.
Affiliation
  • Palanisamy Y; Ortho-One Orthopaedic Speciality Centre, Tamil Nadu, Coimbatore, 641005 India.
  • Naidu SP; Ortho-One Orthopaedic Speciality Centre, Tamil Nadu, Coimbatore, 641005 India.
  • Prasad AR; Ortho-One Orthopaedic Speciality Centre, Tamil Nadu, Coimbatore, 641005 India.
  • Natarajan S; Ortho-One Orthopaedic Speciality Centre, Tamil Nadu, Coimbatore, 641005 India.
  • Rajan DV; Ortho-One Orthopaedic Speciality Centre, Tamil Nadu, Coimbatore, 641005 India.
Indian J Orthop ; 58(1): 30-39, 2024 Jan.
Article in En | MEDLINE | ID: mdl-38161405
ABSTRACT

Background:

Persistent anterior knee pain post total knee arthroplasty (TKA) is a significant cause of patient dissatisfaction. Selective patellar resurfacing is commonly practiced for primary total knee replacement (TKR) but there is a paucity in literature regarding its decision making. Study

Objective:

This study aims to develop a decision-making algorithm for selective patellar resurfacing using Hospital for Special Surgery Patello-femoral Assessment score (HSS PFA score), weight-bearing patellofemoral X-ray, and intraoperative cartilage wear assessment based on the Outerbridge classification. Materials and

Methods:

This prospective study enrolled 65 patients, assessing preoperative factors including HSS PFA score and Baldini view radiography. Intraoperative cartilage wear was categorized using the Outerbridge classification. Preoperative findings were correlated with intraoperative outcomes through statistical analysis, leading to the development of a predictive algorithm. The efficiency of algorithm was assessed at 3-year follow-up using HSS PFA score.

Results:

A significant negative correlation (r = - 0.272, p = 0.029) was observed between HSS PFA score and cartilage wear. However, no significant relationships were established between HSS PFA score and Baldini view observations, including radiological tilt (p = 0.517) and displacement (p = 0.277). Intraoperative cartilage wear versus patellar tilt (p = 0.65) and displacement (p = 0.837) also yielded non-significant results. Three-year follow-up examinations revealed no complications and significant HSS PFA score improvements in all patients.

Conclusion:

The requirement for patellar resurfacing can be predicted using a combination of preoperative parameter such as HSS PFA score and the intra-operative cartilage wear. We put forward an algorithm based on above findings to aid in the decision making.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: Indian J Orthop Year: 2024 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: Indian J Orthop Year: 2024 Document type: Article