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. 2024 Apr;16(2):242-250.
doi: 10.4055/cios22253. Epub 2023 Sep 7.

Patella Cartilage Status Does Not Affect the Clinical Outcomes of Non-resurfaced Patella in Mobile-Bearing Total Knee Arthroplasty

Do Weon Lee  1 , Du Hyun Ro  2   3 , Hyuk-Soo Han  2 , Myung Chul Lee  2
Affiliations

Patella Cartilage Status Does Not Affect the Clinical Outcomes of Non-resurfaced Patella in Mobile-Bearing Total Knee Arthroplasty

Do Weon Lee et al. Clin Orthop Surg. 2024 Apr.

Abstract

Background: During total knee arthroplasty (TKA), patellar retention is performed when the cartilage is fairly well preserved and the thickness of the patella is relatively thin. However, clinical outcomes of the non-resurfaced patella in TKA according to the cartilage status are lacking in the literature. The purpose of this study was to compare patient-reported outcome measures (PROMs) according to the grade and location of the patellar cartilage lesion in TKA patients.

Methods: The outcomes of 165 osteoarthritis patients (186 knees) who underwent cemented mobile-bearing TKA without patellar resurfacing were assessed and classified according to the grade and location of the patellar cartilage lesion. PROMs using the Western Ontario and MacMaster Universities Osteoarthritis index, the Knee Society Score (Knee Society Function Score and Knee Society Knee Score), and the Hospital for Special Surgery score were evaluated preoperatively and at postoperative 2, 4, 6, and 8 years. The correlations between PROMs and the grade and location of the cartilage lesion were assessed. Additionally, radiologic outcomes including the patellar tilt angle and patellar height were assessed and their correlation with the grade of cartilage lesion was analyzed. Analysis of variance was used to determine statistical significance.

Results: There was no significant difference between PROMs according to the grades and locations of cartilage lesions at any postoperative follow-up. Radiologic parameters also showed no significant differences according to the grades of patellar cartilage lesions.

Conclusions: The grade and location of the patellar cartilage lesion had no influence on clinical outcomes in mobile-bearing TKA with patellar retention at short- and long-term follow-up.

Keywords: Articular cartilage; Patella; Total knee arthroplasty.

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Conflict of interest statement

CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Flowchart of patient selection in this study. TKA: total knee arthroplasty.
Fig. 2
Fig. 2. Classification of the location of patellar cartilage lesions: type 1, no or minimal lesion; type 2, medial facet without central ridge; type 3, lateral facet without central ridge; type 4, central ridge only; type 5, medial facet with central ridge; type 6, lateral facet with central ridge; type 7, global lesions. L: lateral facet, C: central ridge, M: medial facet.
Fig. 3
Fig. 3. Skyline radiographs of a patient who underwent total knee arthroplasty using the Low Contact Stress system with patellar preservation. Note that the patella sits congruently on the femoral sulcus of the implant.
See this image and copyright information in PMC

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