Improved postoperative kneeling ability in posterior stabilized total knee arthroplasty with medialized dome-patella resurfacing: A retrospective comparative outcome analysis

Abstract

ObjectivesThis investigation aimed to evaluate if the modifications to prosthesis designs improve patients' clinical and functional outcomes after total knee arthroplasty (TKA), with a special focus on pain and kneeling ability. MethodsRetrospective and comparative analysis of consecutive patients who were treated with posterior stabilized TKA using two different prostheses designs (single surgeon, single vendor). Group 1 received a traditional design TKA (PFC Sigma; DePuy, Inc., Warsaw, IN) with conventional dome-patella resurfacing, and group 2 received a modern design implant (Attune; DePuy, Inc., Warsaw, IN) with medialized dome-patella resurfacing. Functional outcome (range of motion: ROM) and the Oxford Knee Score (OKS) were collected preoperatively, at 4–6 weeks and 12 months following surgery. ResultsNinety-nine participants were included. Of these, 30 received traditional-design implants and 69 received modern-design knee implants. The comparison between the two implants showed a statistically significant increase in total OKS and kneeling ability in the modern design cohort at 1-year follow-up compared to the traditional design cohort (p ​< ​0.01). In the modern design group, 53% (N ​= ​37) could kneel easily or with little difficulty, compared to 30% (N ​= ​9) in the traditional design group. No statistically significant differences in ROM or the OKS pain component were seen. ConclusionThe incorporation of a medialized dome-patella in modern knee implant design may offer advantages over traditional designs, as seen in improved total OKS and kneeling ability at one-year follow-up. Further research with larger cohorts is needed to confirm these findings and explore the broader impact of implant design changes on patient outcomes. Level of evidenceClinical Study, Level III.