Abstract
Introduction: Anterior knee pain (AKP) may persist after total knee arthroplasty (TKA), even if well aligned and stable, and is reported in up to 30% of patients, leading to patient dissatisfaction. The gender-specific knee prostheses have been designed to reduce femoral component overhanging in females and improve patient satisfaction. The purpose of this study was to determine AKP between gender-specific knee prosthesis and unisex knee prosthesis following minimally invasive surgery (MIS) TKA with patellar resurfacing. Methods: This study was a randomized trial comparing a gender-specific vs. unisex knee prosthesis in females with knee osteoarthritis. Follow-up occurred at 6 weeks, 3 months, 6 months, 1 year, and 2 years. Pre- and postoperative AKP were measured at each follow-up. Intraoperative lateral overhanging of the femoral component and patellar tracking were also measured and compared between the two groups. Results: Sixty females were recruited; 30 underwent gender-specific knee prosthesis (Gp1) and 30 underwent unisex knee prosthesis (Gp2). No patients were lost to follow-up. The incidence rates of AKP and visual analog scale AKP pain scores at 2 years were 7 vs. 7% (p = 1.00) and 0.95 ± 0.31 (0–1) points vs. 1.10 ± 0.28 (0–1) points (p = 0.68) for gender and unisex prostheses, respectively. Patellar tilt and patellar shift were similar between the two groups. Patellar tilt and patellar shift were 2.56° ± 2.03 (0–8) vs. 2.67° ± 2.35 (0–9) (p = 0.46) and 1.25 ± 1.09 (0–3.2) mm vs. 1.15 ± 0.97 (0–2.9) mm (p = 0.34) for Gp1 and Gp2, respectively. Mean lateral femoral overhanging was 0.23 ± 0.63 mm (range: 1–2 mm, Gp1) vs. 1.57 ± 1.36 mm (range: 1–3 mm, Gp2) (p ≤ 0.001). Conclusion: Both types of prostheses had similar incidence rates of AKP, VAS scores for AKP. Lateral femoral overhanging of ≤ 3 mm was not the cause of AKP.
Highlights
Total knee arthroplasty (TKA) has shown good outcomes and survivorship [1,2,3,4,5]
The purpose of this study was to determine whether anterior knee pain (AKP) and patellar tracking differ between gender-specific knee prosthesis and
Our study revealed that gender-specific knee prosthesis had the same rates of AKP and VAS for AKP with unisex knee prosthesis
Summary
Total knee arthroplasty (TKA) has shown good outcomes and survivorship [1,2,3,4,5]. postoperative anterior knee pain (AKP) is a common problem after TKA and affects patient satisfaction [6,7,8,9]. Overhang of a femoral prosthesis and overstuffing of the patella may be the cause of AKP [15,16,17]. Gender-specific knee prostheses have been designed for women to reduce the AP:ML ratio of overhang of the femoral component, increase the valgus angle of the trochlea groove, restore the Q-angle, and reduce the thickness of the anterior part of prosthesis to prevent overstuffing of the patella. Previous studies of gender-specific knee prostheses have shown similar clinical outcomes as unisex knee prosthesis. There has been no study comparing the AKP of unisex knee prosthesis with overhanging of the femoral component and gender-specific knee prostheses following minimally invasive surgery (MIS) TKA. The purpose of this study was to determine whether AKP and patellar tracking differ between gender-specific knee prosthesis and
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