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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 25, Issue 12, pp 3747–3754 | Cite as

Comparison of patellofemoral outcomes after TKA using two prostheses with different patellofemoral design features

  • Dae Kyung Bae
  • Jong Hun Baek
  • Kyung Tack Yoon
  • Hyuck Sung Son
  • Sang Jun SongEmail author
Knee

Abstract

Purpose

The purpose of the present study was to compare the clinical and radiographic results after TKA using two prostheses with different sagittal patellofemoral design features, including outcomes related to compatibility of the patellofemoral joint.

Methods

The clinical and radiographic results of 81 patients (100 knees) who underwent TKA using the specific prosthesis (group A) were compared with those in a control group who underwent TKA using the other prosthesis (group B). The presence of anterior knee joint pain, patellar crepitation, and patellar clunk syndrome was also checked.

Results

The function score and maximum flexion angle at the last follow-up were slightly better in group A than those in group B (92.0 ± 2.3 vs. 90.6 ± 4.2) (133.6° ± 8.4° vs. 129.6° ± 11.4°). Anterior knee pain was observed in 6 knees and patellar crepitation in four knees in group A. In group B, these symptoms were observed in 22 knees and 18 knees, respectively. There was no patellar clunk syndrome in either group. The alignment was corrected with satisfactory positioning of components. The patellar height remained unchanged after TKA in the two groups. The differences between preoperative and postoperative patellar tilt angle and patellar translation were small.

Conclusion

When comparing the clinical and radiographic results after TKA using two prostheses with different sagittal patellofemoral design features, TKA using the specific prosthesis provided satisfactory results with less clinical symptoms related to the patellofemoral kinematics with TKA using the other prosthesis.

Level of evidence

III.

Keywords

Knee Total knee arthroplasty Patellofemoral joint compatibility 

References

  1. 1.
    Bae DK, Song SJ, Yoon KH (2010) Total knee arthroplasty following closed wedge high tibial osteotomy. Int Orthop 34:283–287CrossRefPubMedGoogle Scholar
  2. 2.
    Baliga S, McNair CJ, Barnett KJ, MacLeod J, Humphry RW, Finlayson D (2012) Does circumpatellar electrocautery improve the outcome after total knee replacement? A prospective, randomised, blinded controlled trial. J Bone Joint Surg Br 94:1228–1233CrossRefPubMedGoogle Scholar
  3. 3.
    Ballantyne A, McKinley J, Brenkel I (2003) Comparison of the lateral release rates in the press fit condylar prosthesis and the PFC Sigma prosthesis. Knee 10:193–198CrossRefPubMedGoogle Scholar
  4. 4.
    Beight JL, Yao B, Hozack WJ, Hearn SL, Booth RE Jr (1994) The patellar “clunk” syndrome after posterior stabilized total knee arthroplasty. Clin Orthop Relat Res 299:139–142Google Scholar
  5. 5.
    Bellemans J, Banks S, Victor J, Vandenneucker H, Moemans A (2002) Fluoroscopic analysis of the kinematics of deep flexion in total knee arthroplasty. Influence of posterior condylar offset. J Bone Joint Surg Br 84:50–53CrossRefPubMedGoogle Scholar
  6. 6.
    Breugem SJ, van Ooij B, Haverkamp D, Sierevelt IN, van Dijk CN (2014) No difference in anterior knee pain between a fixed and a mobile posterior stabilized total knee arthroplasty after 7.9 years. Knee Surg Sports Traumatol Arthrosc 22:509–516CrossRefPubMedGoogle Scholar
  7. 7.
    Choi WC, Ryu KJ, Lee S, Seong SC, Lee MC (2013) Painful patellar clunk or crepitation of contemporary knee prostheses. Clin Orthop Relat Res 471:1512–1522CrossRefPubMedGoogle Scholar
  8. 8.
    Conrad DN, Dennis DA (2014) Patellofemoral crepitus after total knee arthroplasty: etiology and preventive measures. Clin Orthop Surg 6:9–19CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    D’Lima DD, Chen PC, Kester MA, Colwell CW (2003) Impact of patellofemoral design on patellofemoral forces and polyethylene stresses. J Bone Joint Surg Am 85-A(Suppl 4):85–93CrossRefGoogle Scholar
  10. 10.
    Dejour D, Ntagiopoulos PG, Saffarini M (2014) Evidence of trochlear dysplasia in femoral component designs. Knee Surg Sports Traumatol Arthrosc 22:2599–2607CrossRefPubMedGoogle Scholar
  11. 11.
    Dennis DA, Kim RH, Johnson DR, Springer BD, Fehring TK, Sharma A (2011) The John Insall Award: control-matched evaluation of painful patellar Crepitus after total knee arthroplasty. Clin Orthop Relat Res 469:10–17CrossRefPubMedGoogle Scholar
  12. 12.
    Ewald FC (1989) The knee society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12Google Scholar
  13. 13.
    Frye BM, Floyd MW, Pham DC, Feldman JJ, Hamlin BR (2012) Effect of femoral component design on patellofemoral crepitance and patella clunk syndrome after posterior-stabilized total knee arthroplasty. J Arthroplasty 27:1166–1170CrossRefPubMedGoogle Scholar
  14. 14.
    Fukunaga K, Kobayashi A, Minoda Y, Iwaki H, Hashimoto Y, Takaoka K (2009) The incidence of the patellar clunk syndrome in a recently designed mobile-bearing posteriorly stabilised total knee replacement. J Bone Joint Surg Br 91:463–468CrossRefPubMedGoogle Scholar
  15. 15.
    Heyse TJ, le Chong R, Davis J, Haas SB, Figgie MP, Potter HG (2012) MRI diagnosis of patellar clunk syndrome following total knee arthroplasty. HSS J 8:92–95CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Hozack WJ, Rothman RH, Booth RE Jr, Balderston RA (1989) The patellar clunk syndrome. A complication of posterior stabilized total knee arthroplasty. Clin Orthop Relat Res 241:203–208Google Scholar
  17. 17.
    Indelli PF, Marcucci M, Cariello D, Poli P, Innocenti M (2012) Contemporary femoral designs in total knee arthroplasty: effects on the patello-femoral congruence. Int Orthop 36:1167–1173CrossRefPubMedGoogle Scholar
  18. 18.
    Indelli PF, Marcucci M, Pipino G, Charlton S, Carulli C, Innocenti M (2014) The effects of femoral component design on the patello-femoral joint in a PS total knee arthroplasty. Arch Orthop Trauma Surg 134:59–64CrossRefPubMedGoogle Scholar
  19. 19.
    Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14Google Scholar
  20. 20.
    Kievit AJ, Schafroth MU, Blankevoort L, Sierevelt IN, van Dijk CN, van Geenen RC (2014) Early experience with the vanguard complete total knee system: 2–7 years of follow-up and risk factors for revision. J Arthroplasty 29:348–354CrossRefPubMedGoogle Scholar
  21. 21.
    Kim JH, Lee S, Ko DO, Yoo CW, Chun TH, Lee JS (2011) The analysis of risk factors in no thumb test in total knee arthroplasty. Clin Orthop Surg 3:274–278CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Koh IJ, Kim TK, Chang CB, Cho HJ, In Y (2013) Trends in use of total knee arthroplasty in Korea from 2001 to 2010. Clin Orthop Relat Res 471:1441–1450CrossRefPubMedGoogle Scholar
  23. 23.
    Kong CG, Park SW, Yang H, In Y (2014) The effect of femoral component design on patellar tracking in total knee arthroplasty: genesis II prosthesis versus vanguard prosthesis. Arch Orthop Trauma Surg 134:571–576CrossRefPubMedGoogle Scholar
  24. 24.
    Koninckx A, Deltour A, Thienpont E (2014) Femoral sizing in total knee arthroplasty is rotation dependant. Knee Surg Sports Traumatol Arthrosc 22:2941–2946CrossRefPubMedGoogle Scholar
  25. 25.
    Lombardi AV Jr, Ellison BS, Berend KR (2008) Polyethylene wear is influenced by manufacturing technique in modular TKA. Clin Orthop Relat Res 466:2798–2805CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Lonner JH, Jasko JG, Bezwada HP, Nazarian DG, Booth RE Jr (2007) Incidence of patellar clunk with a modern posterior-stabilized knee design. Am J Orthop (Belle Mead NJ) 36:550–553Google Scholar
  27. 27.
    Maloney WJ, Schmidt R, Sculco TP (2003) Femoral component design and patellar clunk syndrome. Clin Orthop Relat Res 410:199–202CrossRefGoogle Scholar
  28. 28.
    Meftah M, Jhurani A, Bhat JA, Ranawat AS, Ranawat CS (2012) The effect of patellar replacement technique on patellofemoral complications and anterior knee pain. J Arthroplasty 27:1075–1080CrossRefPubMedGoogle Scholar
  29. 29.
    Mugnai R, Digennaro V, Ensini A, Leardini A, Catani F (2014) Can TKA design affect the clinical outcome? Comparison between two guided-motion systems. Knee Surg Sports Traumatol Arthrosc 22:581–589CrossRefPubMedGoogle Scholar
  30. 30.
    Ogawa H, Matsumoto K, Akiyama H (2016) Effect of patellar resurfacing on patellofemoral crepitus in posterior-stabilized total knee arthroplasty. J Arthroplasty. doi: 10.1016/j.arth.2016.01.023 Google Scholar
  31. 31.
    Parker DA, Dunbar MJ, Rorabeck CH (2003) Extensor mechanism failure associated with total knee arthroplasty: prevention and management. J Am Acad Orthop Surg 11:238–247CrossRefPubMedGoogle Scholar
  32. 32.
    Peralta-Molero JV, Gladnick BP, Lee YY, Ferrer AV, Lyman S, Gonzalez Della Valle A (2014) Patellofemoral crepitation and clunk following modern, fixed-bearing total knee arthroplasty. J Arthroplasty 29:535–540CrossRefPubMedGoogle Scholar
  33. 33.
    Saffarini M, Demey G, Nover L, Dejour D (2016) Evolution of trochlear compartment geometry in total knee arthroplasty. Ann Transl Med 4:7CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Schroer WC, Diesfeld PJ, Reedy ME, LeMarr A (2009) Association of increased knee flexion and patella clunk syndrome after mini-subvastus total knee arthroplasty. J Arthroplasty 24:281–287CrossRefPubMedGoogle Scholar
  35. 35.
    Schroer WC, Stormont DM, Pietrzak WS (2014) Seven-year survivorship and functional outcomes of the high-flexion vanguard complete knee system. J Arthroplasty 29:61–65CrossRefPubMedGoogle Scholar
  36. 36.
    Scuderi GR, Windsor RE, Insall JN (1989) Observations on patellar height after proximal tibial osteotomy. J Bone Joint Surg Am 71:245–248CrossRefPubMedGoogle Scholar
  37. 37.
    Tsukamoto R, Williams PA, Shoji H, Hirakawa K, Yamamoto K, Tsukamoto M, Clarke IC (2008) Wear in molded tibial inserts: knee simulator study of H1900 and GUR1050 polyethylenes. J Biomed Mater Res B Appl Biomater 85:314–319CrossRefPubMedGoogle Scholar
  38. 38.
    van Jonbergen HP, Scholtes VA, van Kampen A, Poolman RW (2011) A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing. J Bone Joint Surg Br 93(8):1054–1059. doi: 10.1302/0301-620X.93B8.26560 CrossRefPubMedGoogle Scholar
  39. 39.
    Yau WP, Wong JW, Chiu KY, Ng TP, Tang WM (2003) Patellar clunk syndrome after posterior stabilized total knee arthroplasty. J Arthroplasty 18:1023–1028CrossRefPubMedGoogle Scholar
  40. 40.
    Zha GC, Sun JY, Dong SJ (2014) Less anterior knee pain with a routine lateral release in total knee arthroplasty without patellar resurfacing: a prospective, randomized study. Knee Surg Sports Traumatol Arthrosc 22:517–525CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2016

Authors and Affiliations

  • Dae Kyung Bae
    • 1
  • Jong Hun Baek
    • 1
  • Kyung Tack Yoon
    • 1
  • Hyuck Sung Son
    • 1
  • Sang Jun Song
    • 1
    Email author
  1. 1.Department of Orthopaedic Surgery, College of MedicineKyung Hee UniversitySeoulKorea

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