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Further observations on metal-backed patellar component failure
1Harvard Medical School, Boston, Massachusetts.
Clinical Orthopaedics and Related Research
|November 1, 1988
Summary
Metal-backed patellar component failure is an emerging complication in total knee arthroplasty. Roentgenographic findings are crucial for diagnosis, as clinical data and history are often unhelpful.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Total knee arthroplasty (TKA) is a common procedure for end-stage knee arthritis.
- Metal-backed patellar components are utilized in some TKA designs.
- Implant failure can lead to revision surgery and patient dissatisfaction.
Purpose of the Study:
- To summarize the clinical data, failure patterns, symptoms, roentgenographic findings, and failure mechanisms of metal-backed patellar component failures.
- To evaluate the diagnostic utility of clinical versus roentgenographic findings in these failures.
Main Methods:
- Retrospective review of 25 cases with metal-backed patellar component failure.
- Analysis of clinical data, patient history, and preoperative roentgenographic findings.
- Correlation of findings with intraoperative arthrotomy diagnoses.
Main Results:
- Diagnosis of implant failure was unknown preoperatively in 28% of cases.
- Clinical findings and patient history were not helpful in diagnosing implant failure.
- Roentgenographic findings were instrumental in diagnosis, leading to correct identification in 17 of 18 cases (94%).
Conclusions:
- Metal-backed patellar component failure represents a new and increasing complication of TKA.
- Radiographic assessment is the most reliable method for diagnosing these failures.
- Further research into metal-backed component design is recommended before widespread implantation.