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Press-fit versus cemented all-polyethylene patellar component: midterm results.
Gonzalo G Valdivia1, Michael J Dunbar, Richard J Jenkinson
1Division of Orthopaedic Surgery, London Health Sciences Center, University of Western Ontario, London, Ontario, Canada.
The Journal of Arthroplasty
|January 24, 2002
Summary
Press-fit patellar component implantation shows improved tracking compared to cemented fixation at midterm follow-up. This study suggests press-fit is a viable alternative for all-polyethylene patellar components.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Medical device engineering
Background:
- Patellar component fixation is crucial for total knee arthroplasty outcomes.
- Cemented fixation is standard, but complications like maltracking can occur.
- Press-fit fixation offers a cementless alternative, potentially reducing complications.
Purpose of the Study:
- To compare midterm outcomes of press-fit versus cemented all-polyethylene patellar components.
- To evaluate patellofemoral complications and functional scores between fixation methods.
Main Methods:
- Prospective study of 172 patients with all-polyethylene patellar components (133 cemented, 39 press-fit).
- Average follow-up of 6 years.
- Assessment of patellofemoral complications, including maltracking and revision rates, and Knee Society scores.
Main Results:
- Cemented patellae had a significantly higher incidence of maltracking (30% vs 8%; P= .005).
- Two cemented patellae required revision due to complications.
- No significant differences in overall Knee Society scores were found between groups.
- A fibrous membrane was observed at the press-fit interface, with unknown osteolysis potential.
Conclusions:
- Press-fit implantation of all-polyethylene patellar components may improve patellar tracking compared to cemented fixation at midterm follow-up.
- Press-fit fixation represents a viable alternative to cement fixation for these components.