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Does overstuffing of the patellofemoral joint in total knee arthroplasty have a significant effect on postoperative outcomes?
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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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Official URL: http://dx.doi.org/10.1016/j.knee.2018.05.007
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 | ||||||
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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 |
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Journal or Publication Title: | The Knee | ||||||
Publisher: | Elsevier BV | ||||||
ISSN: | 0968-0160 | ||||||
Official Date: | 20 June 2018 | ||||||
Dates: |
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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 |
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