Department of Orthopaedic Surgery, Sports Trauma Unit, St. Luke's Hospital, Panorama, Thessaloniki, 55236, Greece.
Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon North University Hospital, Lyon, 69004, France.
Arch Orthop Trauma Surg. 2024 Aug;144(8):3649-3655. doi: 10.1007/s00402-024-05485-1. Epub 2024 Aug 6.
The aim of the present study was to report the approach of Greek surgeons regarding patellar management and provide the outcomes and the rate of the need for secondary patella resurfacing.
Following the PRISMA guidelines, PubMed, Scopus, and The Cochrane Central Register of Controlled Trials (CENTRAL) databases were accessed in January 2024. Clinical studies evaluating the outcomes of patients undergoing primary TKA were considered eligible for this systematic review if the following predefined criteria were fulfilled: (1) published in English, (2) were conducted in Greece, and had a minimum of 2-year follow-up. The methodological quality and publication bias were assessed using the Modified Coleman Methodology Score (mCMS) and ROBIS tool, respectively. Data was presented in tables using absolute values from individual studies. Pooled data were presented as means, ranges, and percentages.
Six clinical studies with a total of 1084 TKAs were included. Four studies were retrospectives, and two studies were prospective. Patella was only resurfaced in 0.6% of total TKAs. TKA without patellar resurfaced, which resulted in an improvement in functional outcome. Among studies, the overall need for revision incidence was 7.6% (68 out of 892 TKAs). Additionally, Aseptic loosening (2.4%) was the most common reason for revision due to patellofemoral joint complications, followed by secondary patellar resurfacing (2.1%) and deep infection (1.3%). The mean mCMS demonstrated a fair methodological quality level, and the ROBIS toll a low risk of bias in all four domains.
The available evidence supports that Greek surgeons mainly do not resurface the patella. However, patellar non-resurfacing yields good functional outcomes and presents relatively low revision rates for secondary patellar resurfacing.
IV.
本研究旨在报告希腊外科医生在髌骨处理方面的方法，并提供初次全膝关节置换术（TKA）患者的结果和需要二次髌骨表面置换的发生率。
根据 PRISMA 指南，于 2024 年 1 月检索 PubMed、Scopus 和 The Cochrane Central Register of Controlled Trials（CENTRAL）数据库。如果符合以下预设标准，评估评估初次 TKA 患者结果的临床研究有资格进行本系统评价：（1）发表于英语文献，（2）在希腊进行，并具有至少 2 年的随访。使用改良 Coleman 方法学评分（mCMS）和 ROBIS 工具评估方法学质量和发表偏倚。使用绝对数值以表格形式呈现数据来自个别研究。汇总数据以平均值、范围和百分比呈现。
纳入了 6 项共 1084 例 TKA 的临床研究。4 项研究为回顾性，2 项研究为前瞻性。仅有 0.6%的 TKA 进行了髌骨表面置换。未进行髌骨表面置换的 TKA 导致功能结果改善。在研究中，总体翻修发生率为 7.6%（892 例 TKA 中有 68 例）。此外，由于髌股关节并发症，无菌性松动（2.4%）是翻修的最常见原因，其次是二次髌骨表面置换（2.1%）和深部感染（1.3%）。平均 mCMS 表明方法学质量处于中等水平，ROBIS 工具在所有 4 个领域均显示低偏倚风险。
现有证据支持希腊外科医生主要不进行髌骨表面置换。然而，不进行髌骨表面置换可获得良好的功能结果，且二次髌骨表面置换的翻修率相对较低。
IV 级。
