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International Orthopaedics

, Volume 43, Issue 10, pp 2293–2301 | Cite as

Clinical and radiologic outcomes of two patellar resection techniques during total knee arthroplasty: a prospective randomized controlled study

  • Fuzhen Yuan
  • Zewen Sun
  • Haijun Wang
  • Yourong Chen
  • Jiakuo YuEmail author
Original Paper
  • 197 Downloads

Abstract

Purpose

A cutting guide technique for patella resurfacing in total knee arthroplasty was expected to result in less patellofemoral syndromes. The aim of this study was to identify differences in the patellofemoral function, clinical outcomes, and radiographic parameters between the freehand and cutting guide patellar resection techniques in patients undergoing total knee arthroplasty.

Methods

A prospective randomized controlled trial was conducted. The study was registered in a public trials registry (International Standard Randomized Trial No. NCT02268097). One-hundred total knee arthroplasties in 100 patients were randomly allocated into one of the two groups, and their results were followed for a mean of 28 months (range, 18 to 38 months) in a double-blind (both patient and evaluator), prospective study. Evaluation was performed by an independent observer using patellofemoral functional capacity, the Knee Society clinical rating system, the Western Ontario and McMaster Universities Osteoarthritis Indices, and radiographic examination.

Results

In total, 14% of the patients were lost to follow-up. There was no difference in the incidence of anterior knee pain between the two groups. No patients received or required revisions. There was a significant difference in the outliers of lateral patellar tilt between the freehand and cutting guide groups (> 10°) (p = 0.036); however, the mean value of lateral patellar tilt did not differ significantly. There were no differences between groups with respect to the 30 seconds stair climbing test, complications, the Knee Society clinical rating system, the Western Ontario and McMaster Universities Osteoarthritis Indices, patient satisfaction, physical examination, hip-knee-ankle angle, lateral patellar displacement, or the Insall-Salvati ratio. Meanwhile, gender, age, weight, height, body mass index, pre-operative Knee Society scores, and pre-operative range of motion were not found to be related to the development of anterior knee pain.

Conclusions

Cutting guide technique group did not yield lower incidence of anterior knee pain. More outliers of lateral patellar tilt were observed in the freehand technique group. Overall, all patients in both groups had identical results in terms of patellofemoral functional capacity, clinical outcomes, and other radiographic results.

Keywords

Knee Arthroplasty Patella Freehand Cutting guide 

Notes

Funding

This study was funded by the National Key R&D Program of China (No. 2017YFB1303000).

Compliance with ethical standards

The trial was registered in a public trial registry (International Standard Randomized Trial No. NCT02268097) and was approved by the institutional review board (IRB00006761-2011072). Informed consent was obtained from all enrolled patients.

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

264_2018_4264_MOESM1_ESM.doc (219 kb)
ESM 1 (DOC 219 kb)
264_2018_4264_MOESM2_ESM.doc (54 kb)
ESM 2 (DOC 53 kb)

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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Fuzhen Yuan
    • 1
  • Zewen Sun
    • 1
  • Haijun Wang
    • 1
  • Yourong Chen
    • 1
  • Jiakuo Yu
    • 1
    Email author
  1. 1.Institution of Sports Medicine, Beijing Key Laboratory of Sports InjuriesPeking University Third HospitalBeijingChina

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