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How is patella height modified after total knee arthroplasty?

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Abstract

Introduction

Since the first measurement method of patella height in 1929 (Janssen), more than 16 methods have been described. Most of these measures are not suitable to measure patella height after total knee arthroplasty (TKA). One of us (JC) modified the original Caton Deschamps (oCD), index with a new relative index called modified Caton Deschamps (mCD) index, by using new landmarks. The purpose of this study was to determine how patella height is modified after TKA.

Material and method

Sixty primary TKAs were consecutively prospectively enrolled. One type of implant was used (cementless postero-stabilized TKA, rotating plateau, cemented patella resurfacing). Patient’s characteristics, functional and radiological outcomes were recorded pre-operatively and at one year follow-up. Pre-operative and post-operative outcomes were compared by paired t-test. Post-operative outcomes were compared between groups by one-way analysis of variance.

Results

Average difference between pre and post-operative mCD was 0.19 in this series. In 81.7% of cases, patella was lowered. Patients were classified in three groups according to patella height lowering. Between these three groups, no significant statistical differences (IKS score knee and function, range of motion) could be identified.

Discussion

In TKA, patella assessment in sagittal plane is as important as frontal or horizontal planes. True patella infera (TPI) is mostly due to patella tendon shortening measured by oCD. Pseudo patella infera (PPI) measured by mCD is mostly due to joint line elevation (over femoral cut with an over thickness of the tibial component). In this study a moderate patella lowering (minor than 15%) does not have a significant impact on the functional results (IKS, ROM) nevertheless in 80% patella is lowered. The next step will be to analyze precisely what factors are influencing this lowering and what prevention could be suggested in primary and revision TKA.

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Authors and Affiliations

  1. Clinique des Cèdres, 21 rue Albert Londres, 38432, Echirolles, France

    Jean Louis Prudhon

  2. Clinique Emilie de Vialar, 116 rue Antoine Charial, 69003, Lyon, France

    Jacques H. Caton

  3. Groupe lépine, Genay, 175 rue Jacquard, CS 50307–69727, Genay Cedex, France

    Thierry Aslanian & Régis Verdier

Authors
  1. Jean Louis Prudhon
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  2. Jacques H. Caton
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  3. Thierry Aslanian
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  4. Régis Verdier
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Corresponding author

Correspondence to Régis Verdier.

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Conflict of interest

Jean-Louis Prudhon is consultant for groupe lépine.

Jacques H Caton no conflict of interest.

Thierry Aslanian and Régis Verdier are employed by groupe lépine.

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Prudhon, J.L., Caton, J.H., Aslanian, T. et al. How is patella height modified after total knee arthroplasty?. International Orthopaedics (SICOT) 42, 311–316 (2018). https://doi.org/10.1007/s00264-017-3539-6

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  • DOI: https://doi.org/10.1007/s00264-017-3539-6

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