Tham Sherlyn Yen Yu, Lee Wu Chean, Lim Zavier Yongxuan, Kunnasegaran Remesh
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, 308433, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, 308232, Singapore.
J Clin Orthop Trauma. 2024 Oct 29;58:102798. doi: 10.1016/j.jcot.2024.102798. eCollection 2024 Nov.
Traditional teaching advocates for routine patella resurfacing (PR) during total knee arthroplasty (TKA) in patients with inflammatory arthritis. However, evidence on this topic remains limited in the Asian population. This study aims to evaluate the postoperative outcomes and complication of patella resurfacing (PR) during primary total knee arthroplasty (TKA) in Asian patients with inflammatory arthritis.
A retrospective analysis was conducted using registry data from our institution. Patients with inflammatory arthritis who underwent primary TKA from August 2017 to December 2021 were included in the study. Patients were divided into two groups - patella resurfaced (PR, n = 25) and non-resurfaced patella (PNR, n = 31) groups. Demographics, operative data, patient reported outcome measures, and complications were compared.
Preoperative range of motion (ROM) (PR:95.3 ± 23.6° vs PNR:105 ± 19.5°, p = 0.106), Knee Society Scoring System Knee score (KS-KS) (PR:44.6 ± 17.4 vs PNR:49.3 ± 17.7, p = 0.331) and Knee Society Function Score (KS-FS) (PR:40.9 ± 27.3 vs PNR:47.7 ± 27.0, p = 0.325) and Oxford Knee Score (OKS) (PR:25.0 ± 7.8 vs PNR:23.3 ± 10.3, p = 0.525) were similar in both groups. Outcomes between PR and PNR groups at the one-year mark in terms of ROM (PR:112.7 ± 18.1 vs PNR:114.6 ± 16.5, p = 0.455), OKS (PR:41.5 ± 3.9 vs PNR:41 ± 4.7, p = 0.954), KS-KS (PR:84.5 ± 13.2 vs PNR:89.2 ± 9.3, p = 0.095) and KS-FS (PR:73.6 ± 18.3 vs PNR:78.7 ± 19.3, p = 0.173) were also similar. Intraoperative complication (PR:0/25 vs PNR: 3/31 (9.6 %), p = 0.245) and re-operation rates (PR: 1/25 (4 %) vs PNR: 1/31 (3.2 %), p = 0.877) were also similar in both groups.
This study conducted on a mixed Asian population with inflammatory arthritis demonstrated that the one-year postoperative ROM and functional outcomes, complication, and re-operation rates between PR and PNR groups were similar. Hence, routine patella resurfacing on all Asian patients with inflammatory arthritis undergoing TKA may not be necessary.
传统教学主张在炎性关节炎患者的全膝关节置换术（TKA）中常规进行髌骨置换（PR）。然而，在亚洲人群中，关于这一主题的证据仍然有限。本研究旨在评估亚洲炎性关节炎患者初次全膝关节置换术（TKA）期间髌骨置换（PR）的术后结果和并发症。
使用我们机构的登记数据进行回顾性分析。纳入2017年8月至2021年12月期间接受初次TKA的炎性关节炎患者。患者分为两组——髌骨置换组（PR，n = 25）和未置换髌骨组（PNR，n = 31）。比较人口统计学、手术数据、患者报告的结局指标和并发症。
两组患者术前活动范围（ROM）（PR组：95.3±23.6° vs PNR组：105±19.5°，p = 0.106）、膝关节协会评分系统膝关节评分（KS-KS）（PR组：44.6±17.4 vs PNR组：49.3±17.7，p = 0.331）、膝关节协会功能评分（KS-FS）（PR组：40.9±27.3 vs PNR组：47.7±27.0，p = 0.325）和牛津膝关节评分（OKS）（PR组：25.0±7.8 vs PNR组：23.3±10.3，p = 0.525）相似。PR组和PNR组在术后一年时的ROM（PR组：112.7±18.1 vs PNR组：114.6±16.5，p = 0.455）、OKS（PR组：41.5±3.9 vs PNR组：41±4.7，p = 0.954）、KS-KS（PR组：84.5±13.2 vs PNR组：89.2±9.3，p = 0.095）和KS-FS（PR组：73.6±18.3 vs PNR组：78.7±19.3，p = 0.173）结果也相似。两组的术中并发症（PR组：0/25 vs PNR组：3/31（9.6%），p = 0.245）和再次手术率（PR组：1/25（4%）vs PNR组：1/31（3.2%），p = 0.877）也相似。
这项针对亚洲炎性关节炎混合人群的研究表明，PR组和PNR组术后一年的ROM、功能结局、并发症和再次手术率相似。因此，对于所有接受TKA的亚洲炎性关节炎患者常规进行髌骨置换可能没有必要。
