Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita City, Chiba, Japan.
Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan.
J Knee Surg. 2023 Jun;36(7):773-778. doi: 10.1055/s-0042-1743226. Epub 2022 Feb 21.
Lateral patellar facet impingement (LPFI) can cause anterior knee pain (AKP) after patellar resurfaced total knee arthroplasty (TKA). Recently, lateral patellar facetectomy (LPF), which has been used for LPFI, has been performed during primary TKA, providing good clinical outcomes. However, the effect of LPF on AKP in primary patellar resurfaced TKA has not been sufficiently studied. The purpose of this study was to examine the effect of LPF on the development of AKP in patellar resurfaced TKAs with minimum follow-up of 3 years. This retrospective cohort study included 84 knees of 66 consecutive patients who underwent patellar resurfaced TKA between April 2007 and November 2014 in our hospital. The subjects were divided into two groups: TKA with LPF (LPF group; 47 knees) and TKA without LPF (no-LPF group; 37 knees). Postoperative AKP, the primary outcome, the Japanese Orthopaedic Association (JOA) score, and range of motion were investigated at the final visit and compared between the two groups. Six knees (16.2%) had AKP in the no-LPF group, whereas none of the knees had AKP in the LPF group at the final visit. The incidence of AKP was significantly lower in the LPF group ( = 0.004). The postoperative JOA score and flexion angle were significantly higher in the LPF group than in the no-LPF group. LPF correlated with less incidence of postoperative AKP and improved the JOA score and knee flexion angle. In patellar resurfaced TKA, LPF may be considered an additional maneuver to avoid postoperative AKP.
外侧髌股关节面撞击（LPFI）可导致髌股关节面置换全膝关节置换（TKA）后前膝痛（AKP）。最近，用于治疗 LPFI 的外侧髌股关节面切除术（LPF）已在初次 TKA 中进行，取得了良好的临床效果。然而，LPF 对初次髌股关节面置换 TKA 中 AKP 的影响尚未得到充分研究。本研究旨在检查 LPF 对髌股关节面置换 TKA 中 AKP 发展的影响，随访时间至少为 3 年。本回顾性队列研究纳入了 2007 年 4 月至 2014 年 11 月在我院行髌股关节面置换 TKA 的 66 例连续患者的 84 膝。将受试者分为两组：行 LPF 的 TKA（LPF 组；47 膝）和不行 LPF 的 TKA（无 LPF 组；37 膝）。在末次随访时，对术后 AKP（主要结局）、日本矫形协会（JOA）评分和活动度进行调查，并比较两组之间的差异。无 LPF 组中有 6 膝（16.2%）发生 AKP，而 LPF 组中无膝发生 AKP。LPF 组的 AKP 发生率明显较低（ = 0.004）。LPF 组术后 JOA 评分和屈曲角度均明显高于无 LPF 组。LPF 与术后 AKP 发生率降低和 JOA 评分及膝关节屈曲角度改善相关。在髌股关节面置换 TKA 中，LPF 可能是避免术后 AKP 的一种附加手术方式。
