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The metal-backed patella. An invitation for failure?
J D Peters1, G A Engh, R S Corpe
1Department of Orthopaedics, Fitzsimons Army Medical Center, Aurora, Colorado.
The Journal of Arthroplasty
|September 1, 1991
Summary
Failed metal-backed patellar components are a growing concern, often presenting with delayed diagnosis. This study proposes a specific syndrome and recommends discontinuing these implants to improve patient outcomes.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Metal-backed patellar components are widely used in knee arthroplasty.
- Failures of these components necessitate revision surgery, impacting patient mobility and healthcare costs.
Purpose of the Study:
- To review cases of failed metal-backed patellar components.
- To identify modes of failure and associated delays in presentation and diagnosis.
- To propose a syndrome related to these failures and offer recommendations.
Main Methods:
- Retrospective review of 31 cases of failed metal-backed patellar components requiring revision surgery.
- Analysis of implant failure modes and patient presentation timelines.
- Clinical assessment of diagnostic delays.
Main Results:
- Two distinct modes of implant failure onset were identified.
- Significant delays in patient presentation and diagnosis were observed in all cases.
- A distinct clinical presentation, termed the 'syndrome of the failed metal-backed patellar component,' was observed.
Conclusions:
- Increased incidence of metal-backed patellar component failures is anticipated.
- Patients require thorough counseling on signs/symptoms and frequent follow-up.
- Surgeons must be prepared for revision surgery for all components.
- Discontinuation of metal-backed patellar components is recommended.