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Patellar Rebar Augmentation in Revision Total Knee Arthroplasty
Edward J McPherson1, Sherif M Sherif1, Matthew V Dipane1
1Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.
The Journal of Arthroplasty
|September 21, 2020
Summary
Cortical "rebar" screws effectively augment cement fixation in revision patellar reconstruction, showing a low complication rate and rigid fixation. This technique expands options for complex patellar revision total knee arthroplasty cases.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
- Medical Device Technology
Background:
- Revision total knee arthroplasty (TKA) can result in compromised patellar bone stock due to osteolysis, abrasion, or infection.
- Severe patellar bone deficiencies, including cavitary and rim defects, challenge the secure fixation of patellar implant pegs.
Purpose of the Study:
- To retrospectively evaluate the efficacy of using cortical
- rebar
- screws to enhance cement fixation during revision patelloplasty.
Main Methods:
- The dorsal patellar rebar technique was employed in 128 of 1037 revision TKA cases (12.3%) between 2006 and 2018.
- Clinical outcomes were assessed using serial radiographs and prospective Knee Society Scores (KSSs), alongside evaluation of complications and reoperations.
Main Results:
- The study included 128 patients (69 female, 59 male) with a mean follow-up of 37 months.
- A significant improvement in KSS was observed, from a preoperative average of 50 to 85 at latest follow-up.
- Only 4 patellar-related complications (3.1%) occurred, with no implant failures, and retrieval analysis confirmed rigid fixation.
Conclusions:
- Patellar rebar screw augmentation provides a viable solution for patellar revisions with significant cavitary and limited segmental bone deficiencies.
- This technique effectively extends the surgical indications for patellar revision arthroplasty, improving patient outcomes.
