The influence of retropatellar fat preservation on the positioning of the tibial component of total knee arthroplasty

Abstract

Background: The good clinical-functional outcomes of total knee arthroplasty (TKA) depend on several factors, such as the surgical time and the adequate positioning of the prosthesis components. The present study aims to evaluate whether the preservation of retropatellar fat pad during the surgical act influences the rotational alignment of the tibial component and the surgical time of the procedure. Methods: The study was carried out with 50 patients operated on by the main author, who were randomly divided into two groups, experimental and control. For the evaluation of the positioning of the tibial component, the patients underwent computed tomography (CT) four weeks after the surgery, on average. Casuistry was determined by pilot study with the first five patients of each group. For the sample calculation, the t-student test was used for two independent samples. Results: All patients presented internal rotation of the tibial component, with no statistical difference in mean rotation between the experimental and control groups. When there was complete detachment of the fat in the experimental group, the tibial component showed greater external rotation, with a statistical difference. Surgical time was shorter in the experimental group, varying in this group according to the degree of osteoarthrosis. Conclusions: Maintenance of retropatellar fat pad did not influence the rotational alignment of the tibial component; however, in patients with advanced osteoarthrosis, such maintenance increases the surgical time.