Kleeman-Forsthuber Lindsay T, Angerame Marc, Jennings Jason, Lundy Keanna, Brady Anna, Dennis Douglas A
Colorado Joint Replacement, Denver, CO, USA.
Illinois Bone and Joint Institute, Barrington, IL, USA.
Arthroplast Today. 2023 Mar 7;20:101112. doi: 10.1016/j.artd.2023.101112. eCollection 2023 Apr.
Patellofemoral crepitus is an unfavorable complication following total knee arthroplasty (TKA) with a posterior-stabilized (PS) implant. The purpose of this study was to study patellar crepitus recurrence and reoperation rates following arthroscopic debridement in patients with a PS-TKA.
Our institution database was used to identify patients with a PS-TKA who underwent arthroscopic debridement for patellofemoral crepitus at our institution. Patients must have had a resurfaced patella and minimum 2 years clinical follow-up from the arthroscopic debridement to be included in the study. Recurrence of patellar crepitus, subsequent operations, and any adverse events were documented.
We identified 35 patients who met inclusion criteria with an average follow-up of 8.0 years (range 2.1 to 18.4 years) from their arthroscopic debridement. Nineteen patients (54.3%) had history of a nonarthroplasty knee surgery prior to their TKA. The mean time interval between TKA and arthroscopic debridement for patellar crepitus was 1.6 years (range 0.2 to 5.0 years). Overall, 16 patients (45.7%) developed recurrent crepitus (8 asymptomatic and 8 symptomatic). Six of the symptomatic patients (17.1% of the entire cohort) underwent a repeat surgery for recurrent patellofemoral crepitus. Of theses 6 patients, 3 developed recurrent crepitus but only 1 patient had a third surgical procedure. No postoperative complications were noted following any surgical procedure. The mean knee range of motion following arthroscopic debridement did not change (126.9° preoperatively vs 127.0° postoperatively).
Patients experienced high rates of recurrent patellofemoral crepitus following arthroscopic debridement. One-sixth of the patient cohort required a second surgical intervention for recurrent crepitus.
髌股关节摩擦音是采用后稳定型（PS）假体进行全膝关节置换术（TKA）后出现的不良并发症。本研究旨在探讨接受关节镜下清创术的PS-TKA患者的髌股关节摩擦音复发率和再次手术率。
利用本机构数据库识别在本机构接受关节镜下清创术治疗髌股关节摩擦音的PS-TKA患者。患者必须有髌骨表面置换且自关节镜下清创术起至少有2年的临床随访才能纳入本研究。记录髌股关节摩擦音的复发情况、后续手术及任何不良事件。
我们确定了35例符合纳入标准的患者，自关节镜下清创术起平均随访8.0年（范围2.1至18.4年）。19例患者（54.3%）在TKA之前有非关节置换膝关节手术史。TKA与因髌股关节摩擦音进行关节镜下清创术之间的平均时间间隔为1.6年（范围0.2至5.0年）。总体而言，16例患者（45.7%）出现复发性摩擦音（8例无症状，8例有症状）。6例有症状的患者（占整个队列的17.1%）因复发性髌股关节摩擦音接受了再次手术。在这6例患者中，3例出现复发性摩擦音，但只有1例患者接受了第三次手术。任何手术均未出现术后并发症。关节镜下清创术后膝关节的平均活动范围未改变（术前126.9°，术后127.0°）。
关节镜下清创术后患者髌股关节摩擦音复发率较高。六分之一的患者队列因复发性摩擦音需要进行二次手术干预。
