Abstract
Introduction
The role of secondary patellar resurfacing (SPR) in anterior knee pain (AKP) is still debated in literature. A regional arthroplasty registry was investigated, aiming to: (1) assess the survival rate of SPR; and (2) compare SPR to tricompartmental TKA.
Materials and methods
The regional arthroplasty registry RIPO was investigated about all SPRs performed after bicompartmental arthroplasty. The survival rates and the reasons for revision were assessed as any other factor that could have influenced implants failure. SPR survivorship was compared to tricompartmental TKAs.
Results
406 SPRs performed after bicompartmental arthroplasty were analyzed. The survival rates were 80.6% (CI 95% 75.9–84.5) at 5 years and 77.6% (CI 95% 72.4–82) at 7 years. Half of the SPRs was performed 0.9–2.4 years after the index bicompartmental arthroplasty. SPR achieved lower survival than tricompartmental TKA (80.6% vs 96.7%, p < 0.001), with an adjusted hazard ratio for failure of 5.5 (CI 95% 4.2–7.1, p < 0.001). SPRs performed within 2 years after primary implant had a significantly higher rates of failure when compared to tricompartmental TKA (HR: 6.4, CI 95% 4.8–8.4, p < 0.001).
Conclusion
SPR after bicompartmental knee arthroplasty showed modest 5- and 7-year survival rates, worse than primary tricompartmental TKA. When SPRs are performed within 2 years after primary arthroplasty, a significant higher risk of failure should be expected, highlighting than appropriate pre-operative work-up and patient selection is crucial for SPR successful outcome.
Level of evidence
III, therapeutic study.
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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request. Some data are publicly available at RIPO (http://ripo.cineca.it/authzssl/index.htm).
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FP concepted the design of the study, wrote the manuscript and corrected the final version. CA and BB provided the data, analyzed the data and conducted the statistical analysis. FP, FG and FP wrote the manuscript. FG, FC, FT designed the study, supervised the article production and corrected the final paper. All the Authors read and approved the final version.
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Pardo, F., Giardina, F., Ancarani, C. et al. Higher failure rate of secondary patellar resurfacing following bicompartmental knee arthroplasty. Arch Orthop Trauma Surg 143, 6315–6321 (2023). https://doi.org/10.1007/s00402-023-04924-9
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DOI: https://doi.org/10.1007/s00402-023-04924-9