Severity of patellofemoral osteoarthritis does not affect the prognosis of total knee arthroplasty with patella retention / 中国组织工程研究

ABSTRACT

BACKGROUND: There is no uniform standard on whether the patella is replaced in total knee arthroplasty. There are many control studies on patella replacement versus non-replacement, but few studies compare the prognosis of non-replacement patella according to the severity grade of patellofemoral arthritis. OBJECTIVE: To compare the effects of patellofemoral arthritis on prognosis of total knee arthroplasty with patella retention according to the severity of patellofemoral arthritis, METHODS: One hundred and ninety-two cases of total knee arthroplasty who received patella retention with Depuy Synthes prosthesis in the First Affiliated Hospital of Zhengzhou University from January 2016 to January 2017 were retrospectively analyzed, and the follow-up time was more than 2 years. According to the Lwano classification system, the imaging severity of patellofemoral arthritis was graded into mild group (0-I period, n-83) and severe group (phase II—IV, n=109). All patients signed the informed consents and the study was approved by the hospital ethics committee. Clinical prognosis was assessed by Knee Society Score, functional score, Feller score and anterior knee pain score. The imaging prognosis was assessed by patella tilt angle, fit angle, patella displacement distance and patellar ligament ratio. The statistical method of t test was used to analyze the clinical and imaging results before and after surgery. RESULTS AND CONCLUSION: (1) One patient had persistent anterior knee pain, and one patient had wound effusion and secondary healing after debridement. The remaining patients achieved first-stage healing. (2) There were significant differences in the preoperative functional scores and Knee Society Score between mild and severe groups (P 0.05). (3) There was a significant difference between two groups in the patella tilt angle, fit angle and patella displacement distance before surgery (P 0.05). (4) In summary, after at least 2 years of follow-up, the severity of patellofemoral arthritis makes no effect on the clinical and imaging prognosis of patients undergoing total knee arthroplasty with patella retention. Even in patients with severe patellofemoral arthritis, a good prognosis is obtained after total knee arthroplasty with patella retention.