An Application of the Isolated Patellar Resurfacing IPR
0An Application of the Isolated Patellar Resurfacing (IPR) in the Treatment of
Anterior Knee Pain in the Post arthroplasty Patient
Layman Abstract : Total knee replacement (TKA) is a common surgery for treating severe knee arthritis. In some cases, surgeons choose not to replace the kneecap (patella) to reduce the risk of future complications. However, some patients continue to experience knee pain after surgery. This study examined whether resurfacing the patella later, as a separate procedure, could improve patient outcomes.
The study followed 33 patients (22 women and 11 men) who had their patella resurfaced after a previous knee replacement. On average, the second surgery was done about two years after the first. Patient satisfaction and knee function were measured using the Knee Society Score (KSS).
Results showed significant improvement in both knee function and overall satisfaction. The average KSS improved from 41.6 to 64.9 for objective measures and from 41.6 to 60.5 for functional ability. However, 6% of patients needed further surgery. The study found that men and non-obese patients tended to have better results.
In conclusion, resurfacing the patella can help improve knee function and reduce pain in certain patients after knee replacement. However, not all patients experience complete relief. This procedure should be considered only if at least 12 months have passed since the first surgery, there is no sign of infection, and the knee implant is properly aligned.
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Original Abstract : Background: Total knee arthroplasty (TKA) has become the main surgical tool in the treatment of primary osteoarthritis of the knee. Outcomes appear to be similar both clinically and functionally, with or without patellar resurfacing.
Purpose: Patellar resurfacing during prosthetic replacement of the knee is associated with loosening and the need for secondary revision. In many cases, the patella is left unreplaced during this procedure in order to decrease the revision risk. Some of these patients remain symptomatic after knee replacement. Secondary isolated resurfacing of the previously unresurfaced patella in total knee arthroplasty remains controversial. The aim of this retrospective study was to evaluate the outcome after isolated patellar resurfacing (IPR) as a second-stage procedure.
Methods: The study included 33 patients (22 females/11 males) who underwent resurfacing of the patella with a mean follow-up of 44.8 ± 12.2 months. The mean age of the patients was 70.3 ± 15 (range 39–95) years at the time of operation. The average period between total knee arthroplasty and patellar resurfacing was 23.3 ± 15.2 months. The patient’s subjective satisfaction was assessed according to the Knee Society Score (KSS) questionnaire.
Results: The mean objective KSS improved significantly from 41.6 ± 9 to 64.9 ± 11 (P less than .01). The mean functional KSS also improved significantly from 41.6 ± 8 to 60.5 ± 9 (P less than .01). Two patients (6%) needed further operative revision. Multivariate analysis indicates that results are better in males and in non-obese patients.
Conclusions. Although clinical scores showed significant improvement, some patients have pain and remain dissatisfied following IPR. IPR should be considered in patients who underwent prosthetic knee bicompartmental. Patellar resurfacing should be considered if there is no evidence of prosthetic component malalignment and at least 12 months have passed since the primary implantation. Some patients are likely to suffer from AKP after knee arthroplasty. In persistent AKP, IPR should be performed provided there is no component malalignment per computerized tomography, no evidence of infection and preferably in a nonobese patient.
View book:- https://doi.org/10.9734/bpi/msti/v3/3956
#Kneearthroplasty #patellareplacement #osteoarthritis #anteriorkneepain #kneereplacementcomplications
#surgery #kneepain #relief