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Total knee arthroplasty in patients after patellectomy
K R Larson1, A Cracchiolo, F J Dorey
1University of California, Los Angeles, School of Medicine, Center for the Health Sciences, 90024-6902.
Clinical Orthopaedics and Related Research
|March 1, 1991
Summary
Total knee arthroplasty (TKA) in patients without a patella showed satisfactory outcomes, though outcomes were lower than in patients with patellae. Patients without patellae may face a higher risk of prosthesis failure.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Patellectomy, the surgical removal of the kneecap, presents unique challenges for total knee arthroplasty (TKA).
- Outcomes of TKA in patients with prior patellectomy are not well-established compared to those with intact patellae.
Purpose of the Study:
- To evaluate the clinical outcomes of total knee arthroplasty (TKA) in patients who have undergone patellectomy.
- To compare the results of TKA in patellectomy patients with a matched control group with patellae.
Main Methods:
- Retrospective evaluation of 26 TKAs in 22 patients with prior patellectomy (14 primary, 12 revision).
- Comparison with a matched control group of 14 knees with intact patellae.
- Assessment of outcomes based on clinical ratings, including pain, range of motion, and functional scores.
Main Results:
- The primary TKA group (no patella) had 7 good/excellent, 2 fair, and 3 poor outcomes.
- The control group (with patella) showed significantly better results: 12 good/excellent, 3 fair, and 0 poor.
- Postoperative pain, flexion contracture, extension lag, and range of motion were significant predictors of final scores.
Conclusions:
- Total knee arthroplasty (TKA) can yield satisfactory results in patients without patellae, justifying its use.
- Patients without patellae may have an increased risk of TKA prosthesis failure, necessitating careful consideration.
- Further research into optimizing TKA in patellectomy patients is warranted to mitigate revision rates.