Hospital for Special Surgery, New York, USA.
Evangelisches Krankenhaus, Wien, Austria.
J Orthop Surg Res. 2023 Apr 28;18(1):325. doi: 10.1186/s13018-023-03705-9.
Patellar resurfacing is considered the standard of care for total knee arthroplasty in the USA. Complications of patella resurfacing include aseptic loosening or patella fractures and can threaten the integrity of the extensor mechanism. The goal of this study was to report on patella button revision rates in posterior stabilized total knee arthroplasty.
Between 01/2010 and 08/2016 patella buttons were implanted in 1056 patients (267 men and 550 women) as part of a posterior stabilized total knee arthroplasty.
Of 1056 cases, 35 cases (14 women, 15 men, 5 bilateral, 3.3%) showed early loosening at a mean 52.5 months postoperatively. Patella components of 38 mm or larger diameters showed a significantly higher loosening rate than the 29, 32, 35 mm buttons (p < 0.01). Mean BMI of patients identified with aseptic loosening was 31.7 kg/m, mean age at time of revision surgery was 63.3 years. All of the patients with loosening of the patella button required revision surgery; in 33 cases an exchange of the button was performed, in two cases a removal of the button and patellar bone grafting was indicated. No complications occurred after revision surgery.
The current study reports a 3.3% patella loosening rate during this mid-term follow-up. Size 38 mm and larger patella components showed a significantly higher revision rate than smaller buttons and the authors advise caution when using large diameter patella components.
在美国，髌骨表面置换被认为是全膝关节置换的标准治疗方法。髌骨表面置换的并发症包括无菌性松动或髌骨骨折，可能会威胁伸肌机制的完整性。本研究的目的是报告后稳定型全膝关节置换中髌骨纽扣翻修率。
在 2010 年 1 月至 2016 年 8 月期间，作为后稳定型全膝关节置换的一部分，在 1056 例患者（267 例男性和 550 例女性）中植入了髌骨纽扣。
在 1056 例病例中，35 例（14 例女性，15 例男性，5 例双侧，3.3%）在术后平均 52.5 个月时出现早期松动。直径为 38mm 或更大的髌骨组件显示出明显更高的松动率，明显高于 29mm、32mm 和 35mm 纽扣（p<0.01）。发生无菌性松动的患者的平均 BMI 为 31.7kg/m2，翻修手术时的平均年龄为 63.3 岁。所有髌骨纽扣松动的患者均需要翻修手术；在 33 例中，更换了纽扣，在 2 例中，需要去除纽扣和髌骨植骨。翻修手术后没有发生并发症。
本研究报告了在这个中期随访中 3.3%的髌骨松动率。直径为 38mm 或更大的髌骨组件的翻修率明显高于较小的纽扣，作者建议在使用大直径髌骨组件时要谨慎。
