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One-peg versus three-peg patella component fixation in total knee arthroplasty
C M Larson1, C M McDowell, P F Lachiewicz
1University of North Carolina-Chapel Hill, Department of Orthopaedics, 27599, USA.
Clinical Orthopaedics and Related Research
|November 22, 2001
Summary
This study compared patella fixation in total knee arthroplasty. While the three-peg design showed a trend towards fewer fractures, neither fixation method demonstrated a significant advantage or disadvantage in this patient cohort.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
- Clinical Research
Background:
- Total knee arthroplasty (TKA) often involves patellar resurfacing.
- Historically, a single central peg was used for patellar component fixation.
- A newer design utilizes three small pegs for cement fixation, with some reports of failure.
Purpose of the Study:
- To prospectively compare the outcomes of two patellar component fixation designs in posterior-stabilized TKA.
- To evaluate the incidence of patellar fracture, anterior knee pain, and other complications associated with each fixation type.
Main Methods:
- Prospective, consecutive study of 228 posterior-stabilized TKAs performed by a single surgeon.
- Group A (84 knees): central peg all-polyethylene patella component.
- Group B (144 knees): three-peg patella component.
Main Results:
- Mean follow-up: 6.7 years (Group A) and 3.5 years (Group B).
- Patella fracture prevalence: 4.7% (Group A) vs. 2.1% (Group B), not statistically significant.
- Anterior knee pain: 7.1% (Group A) vs. 9% (Group B). No patella clunk, subluxation, or peg fracture observed.
Conclusions:
- The three-peg patella design did not show a statistically significant advantage over the central peg design in this cohort.
- No increased risk of component failure was identified with the three-peg patella design at this follow-up duration.
- Further long-term studies may be needed to fully elucidate any differences in complication rates.