A randomized, controlled, prospective study evaluating the effect of patellar eversion on functional outcomes in...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Rehabilitation Science

Background:

• The optimal patellar mobilization technique in total knee arthroplasty (TKA) is debated.
• Lateral patellar retraction is proposed as a potentially beneficial alternative to patellar eversion.

Purpose of the Study:

• To compare the postoperative outcomes of TKA using lateral patellar retraction versus patellar eversion.
• To test the hypothesis that lateral retraction offers comparable results to eversion.

Main Methods:

• 120 patients with degenerative arthrosis underwent primary TKA and were randomized to lateral retraction or eversion.
• Primary outcome: one-year dynamometer-measured quadriceps strength.
• Secondary outcomes: straight-leg raise, pain, walking distance, length of stay, SF-36 scores, range of motion, and radiographic patellar parameters.

Main Results:

• No significant differences were found between the lateral retraction and eversion groups at one year post-TKA.
• Quadriceps strength, range of motion, and SF-36 scores showed significant improvement from baseline in both groups, with no inter-group differences.
• Radiographic measures of patella baja and tilt also showed no significant differences between the techniques.

Conclusions:

• Lateral patellar retraction is not superior to patellar eversion in TKA regarding one-year quadriceps strength or other assessed outcomes.
• Both patellar mobilization techniques result in comparable postoperative functional and radiographic results.