Kemp, Mark A., Metcalfe, Andrew J., Sayers, Adrian, Wylde, Vikki, Eldridge, Jonathan D. and Blom, Ashley W. (2018) Does overstuffing of the patellofemoral joint in total knee arthroplasty have a significant effect on postoperative outcomes? The Knee . doi:10.1016/j.knee.2018.05.007 ISSN 0968-0160.
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Abstract
Background: There is ongoing debate in the literature as to whether or not patellofemoral joint overstuffing has a clinically significant effect on postoperative outcomes following total knee arthroplasty (TKA). This study investigates the effect of patellofemoral joint overstuffing on patient-reported outcomes using novel methods of radiographic measurement.
Methods: The study population consisted of a prospective cohort of 266 patients receiving a Triathlon® (Stryker, Kalamazoo, MI, USA) TKA between 2006 and 2009. Participants completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire preoperatively and at 12 months postoperatively. Pre- and postoperative radiographic measurements were taken according to a defined protocol to assess for patellofemoral overstuffing. Measurement reproducibility was assessed using inter-observer intraclass correlation coefficients. Associations between radiographic measurements and patient-reported outcomes were analysed using linear regression analysis.
Results: A total of 107 patients had adequate images and were included in the analysis for this study. Three different radiographic measurements were used to identify patellofemoral overstuffing all with good intra- and inter-observer reliability. There was no association identified between combined (patella and trochlea) patellofemoral overstuffing measurements and WOMAC scores. However, a statistically significant association was identified between an increase in anterior trochlear offset and worse knee pain and function scores (P < 0.05).
Conclusions:
There is no identifiable association between true patellofemoral overstuffing and clinical outcome; however, there is a small association with the anterior trochlear offset though further studies are warranted to confirm the clinical significance of this finding.
| Item Type: | Journal Article |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
| Journal or Publication Title: | The Knee |
| Publisher: | Elsevier BV |
| ISSN: | 0968-0160 |
| Official Date: | 20 June 2018 |
| Dates: | Date Event 20 June 2018 Available 1 January 2018 Accepted |
| DOI: | 10.1016/j.knee.2018.05.007 |
| Status: | Not Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Restricted or Subscription Access |
| Date of first compliant deposit: | 23 July 2018 |
| URI: | https://wrap.warwick.ac.uk/105353/ |
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