- 作者：Hiroyasu Ogawa ; MD ; PhD ; Kazu Matsumoto ; MD ; PhD ; Haruhiko Akiyama ; MD ; PhD
- 关键词：patellar resurfacing ; patellofemoral crepitus ; patellar tilt ; patellar shift ; total knee arthroplasty
- 刊名：The Journal of Arthroplasty
- 出版年：2016
- 出版时间：August 2016
- 年：2016
- 卷：31
- 期：8
- 页码：1792-1796
- 全文大小：542 K
Methods
This study included 84 knees from 69 patients who underwent TKA using the Vanguard Complete Total Knee System, with or without PR (n = 42 each). Clinical evaluation of the incidence of PC; Knee Society Score; and radiographic measurements of patellar tilt, patellar distance, patellar shift, Insall-Salvati ratio, patellar flexion, femorotibial angle; and rotation of the femoral component was performed. Parameters were evaluated preoperatively and at postoperative months 2, 6, 12, and 24. Logistic regression analysis was conducted to investigate the effect of PR on the risk of PC.
Results
The incidence of PC was significantly higher in the non-PR group than the PR group (33.3% vs 4.8%). The knees of the PR group displayed a significantly increased patellar tilt, medially shifted patella, and decreased patella flexion angle compared with those of the non-PR group. There were no significant differences in the other radiographic parameters or Knee Society Score. The absence of PR was associated with a much higher risk of PC (odds ratio, 10.37; 95% confidence interval, 2.18-10.37).
Conclusion
PR may decrease the incidence of PC by increasing the patellar tilt and medial shift and positioning the patella more closely parallel to the femur. PR is recommended during TKA with this prosthesis.