Abstract
This randomized comparative study was conducted to investigate the outcomes of patellar resurfacing with a medialized dome or an anatomical type in patients receiving primary unilateral posterior-stabilized TKA. Between March 2019 and January 2021, 98 knees were randomly assigned to receive patellar resurfacing by a medialized dome type (group D, 49 knees) or an anatomic type (group A, 49 knees). The primary outcome was the Knee Injury and Osteoarthritis Outcome Score. The secondary outcomes were the Western Ontario and McMaster Universities Osteoarthritis Index, Feller’s patella score, the Kujala anterior knee pain score, knee joint range of motion (ROM), and postoperative complications, including periprosthetic patellar fracture, patellar tilt angle, and lateral patellar shift. Patient-reported outcomes were not significantly different between the two groups. The ROM of the knee joint was significantly better in group A at six months after surgery (p = 0.021). No complications such as patellar fractures were observed. The anatomic type of patellar component showed a significant improvement of the patellar tilt angle after surgery compared with the medialized dome type of component. However, there were no significant differences in patient-reported clinical outcomes between the two groups during the follow-up period of 12 months.
Highlights
Various designs of patellar components have been used in total knee arthroplasty (TKA), including dome, medialized dome, oval, and anatomical types [1–3]
The statistical significance was set at p < 0.05. This A total of 98 knees were recruited into the study, 49 of which received patellar resurfacing using a medialized dome-type patellar component, and 49 of which received with an anatomic-type patellar component
There was no significant difference in the baseline characteristics between the two groups (Table 1)
Summary
Various designs of patellar components have been used in total knee arthroplasty (TKA), including dome, medialized dome, oval, and anatomical types [1–3]. They vary from implant to implant or even within the same implant, and most are made of ultrahigh molecular weight polyethylene [4,5]. With the recent development of TKA design, an anatomic type of patellar component, with the theoretical advantages of optimizing the conformity of the patello-femoral (P-F). Some studies related to P-F kinematics according to patellar component design have been reported [5,7,8]. Even if a patellar component with this advanced design has the theoretical advantages of kinematics, there has been a paucity of literature regarding whether it leads to clinically improved patient-reported outcomes
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