Payne Camryn S, Deckey David G, Verhey Jens T, Van Schuyver Paul R, Bingham Joshua S, Spangehl Mark J
Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona.
Department of Orthopedics, Mayo Clinic, Phoenix, Arizona.
J Arthroplasty. 2025 Feb;40(2):367-372. doi: 10.1016/j.arth.2024.08.033. Epub 2024 Sep 7.
International rates of patellar resurfacing in primary total knee arthroplasty (TKA) are highly variable. This study sought to determine how trends in patellar resurfacing rates have changed between 2004 and 2022. In addition, we investigated how modern rates of revision have varied between resurfaced and unresurfaced patellae in primary TKA among national joint registries.
Data between 2004 and 2022 was obtained either from the publicly available joint registry annual reports, a literature review, or via direct correspondence with registry personnel in Sweden, New Zealand, Australia, the United States, Norway, the United Kingdom, the Netherlands, Switzerland, Canada, and India. Only English language national joint registries or data via direct correspondence with registry administrators were utilized. Additionally, the 10-year cumulative risk of revision TKA with and without patellar resurfacing was pulled from those registries that had this data available.
There were persistent differences in the rates of patellar resurfacing among countries. Australia documented a 40% increase in patellar resurfacing rates, while other countries demonstrated modest or little change in resurfacing rates. This may indicate that surgeons are making the decision to resurface based on national TKA revision rates. The average rates of patellar resurfacing in primary TKA ranged from 4% in Sweden to 94% in the United States. Canada, the United States, Australia, and Switzerland documented a lower risk of revision when the patella was resurfaced, while Sweden, conversely, showed a higher risk of revision with resurfacing.
Rates of patellar resurfacing in primary TKA were highly variable among countries, as were rates of change over time. It appears that the optimal patellar resurfacing strategy may depend mostly on unique patient factors and surgeon expertise. Future studies should attempt to elucidate the individual patient characteristics that contribute to increased risks of revision or anterior knee pain to determine who will most benefit from patellar resurfacing in primary TKA.
初次全膝关节置换术（TKA）中髌骨表面置换的国际比率差异很大。本研究旨在确定2004年至2022年间髌骨表面置换率的趋势是如何变化的。此外，我们调查了在国家关节登记处中，初次TKA中已进行表面置换和未进行表面置换的髌骨之间，现代翻修率是如何变化的。
2004年至2022年的数据来自公开的关节登记处年度报告、文献综述，或通过与瑞典、新西兰、澳大利亚、美国、挪威、英国、荷兰、瑞士、加拿大和印度的登记处人员直接通信获得。仅使用英语国家的关节登记处或通过与登记处管理员直接通信获得的数据。此外，从有该数据的登记处提取了有和没有髌骨表面置换的翻修TKA的10年累积风险。
各国之间髌骨表面置换率存在持续差异。澳大利亚记录的髌骨表面置换率增加了40%，而其他国家的表面置换率变化不大或几乎没有变化。这可能表明外科医生是根据国家TKA翻修率来决定是否进行表面置换的。初次TKA中髌骨表面置换的平均比率从瑞典的4%到美国的94%不等。加拿大、美国、澳大利亚和瑞士记录到，髌骨进行表面置换时翻修风险较低，而瑞典则相反，表面置换后翻修风险较高。
各国初次TKA中髌骨表面置换率差异很大，随时间的变化率也是如此。最佳的髌骨表面置换策略似乎可能主要取决于独特的患者因素和外科医生的专业知识。未来的研究应试图阐明导致翻修风险增加或前膝痛的个体患者特征，以确定谁将在初次TKA中从髌骨表面置换中获益最大。
