Patellar Tracking in Total Knee Arthroplasty—Influence on Clinical and Functional Outcome

Anterior knee pain is a common problem after primary total knee arthroplasty (TKA). The aim of this study was to find parameters in patellar positioning which influence the clinical and functional outcome after TKA. Included were 59 patients who underwent TKA, of which three patients were treated bi...

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Main Authors: Sebastian Dahlmann, Katharina Ziegeler, Anett Mau-Möller, Wolfram Mittelmeier, Philipp Bergschmidt
Format: Article
Language:English
Published: MDPI AG 2022-04-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/12/5/1082
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author Sebastian Dahlmann
Katharina Ziegeler
Anett Mau-Möller
Wolfram Mittelmeier
Philipp Bergschmidt
author_facet Sebastian Dahlmann
Katharina Ziegeler
Anett Mau-Möller
Wolfram Mittelmeier
Philipp Bergschmidt
author_sort Sebastian Dahlmann
collection DOAJ
description Anterior knee pain is a common problem after primary total knee arthroplasty (TKA). The aim of this study was to find parameters in patellar positioning which influence the clinical and functional outcome after TKA. Included were 59 patients who underwent TKA, of which three patients were treated bilaterally (<i>n</i> = 62 included knees). In a periodical follow-up of up to 5 years, each patient had to answer three questionnaires (HSS, WOMAC, SF-36) and underwent three radiographies of the knee (including merchant view) and a clinical examination, including Range Of Motion (ROM). All radiographs were evaluated by a single observer blinded to clinical data, who collected multiple parameters of sagittal and axial patellar alignment including newly developed methods for measuring patellar shift and tilt. Depending on the measurement results, three groups were built for each parameter and the influence on the outcome was determined. A lateral patellar tilt of more than 4° resulted in lower scores for both the HSS and WOMAC. The rarely investigated patellar facet angle showed a significantly inferior clinical and functional outcome in late follow-up of >24 months if lower than 142°, possibly due to progressive osteosclerotic changes of the patella caused by increased contact stress with corresponding patellar morphology. No significant difference was found for all other parameters. The newly developed method for measuring patellar shift has proven to be a valuable and easy instrument in the postoperative setting.
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spelling doaj.art-090253afc1174f4686a9e87ada0c7e6c2023-11-23T10:39:05ZengMDPI AGDiagnostics2075-44182022-04-01125108210.3390/diagnostics12051082Patellar Tracking in Total Knee Arthroplasty—Influence on Clinical and Functional OutcomeSebastian Dahlmann0Katharina Ziegeler1Anett Mau-Möller2Wolfram Mittelmeier3Philipp Bergschmidt4Department of Radiology, Charité Universitätsmedizin Berlin, Luisenstraße 7, 10117 Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin, Luisenstraße 7, 10117 Berlin, GermanyOrthopaedic Clinic and Outpatient Department, University Medicine Rostock, Doberaner Straße 142, 18057 Rostock, GermanyOrthopaedic Clinic and Outpatient Department, University Medicine Rostock, Doberaner Straße 142, 18057 Rostock, GermanyOrthopaedic Clinic and Outpatient Department, University Medicine Rostock, Doberaner Straße 142, 18057 Rostock, GermanyAnterior knee pain is a common problem after primary total knee arthroplasty (TKA). The aim of this study was to find parameters in patellar positioning which influence the clinical and functional outcome after TKA. Included were 59 patients who underwent TKA, of which three patients were treated bilaterally (<i>n</i> = 62 included knees). In a periodical follow-up of up to 5 years, each patient had to answer three questionnaires (HSS, WOMAC, SF-36) and underwent three radiographies of the knee (including merchant view) and a clinical examination, including Range Of Motion (ROM). All radiographs were evaluated by a single observer blinded to clinical data, who collected multiple parameters of sagittal and axial patellar alignment including newly developed methods for measuring patellar shift and tilt. Depending on the measurement results, three groups were built for each parameter and the influence on the outcome was determined. A lateral patellar tilt of more than 4° resulted in lower scores for both the HSS and WOMAC. The rarely investigated patellar facet angle showed a significantly inferior clinical and functional outcome in late follow-up of >24 months if lower than 142°, possibly due to progressive osteosclerotic changes of the patella caused by increased contact stress with corresponding patellar morphology. No significant difference was found for all other parameters. The newly developed method for measuring patellar shift has proven to be a valuable and easy instrument in the postoperative setting.https://www.mdpi.com/2075-4418/12/5/1082total knee arthroplastyanterior knee painpatellar tracking
spellingShingle Sebastian Dahlmann
Katharina Ziegeler
Anett Mau-Möller
Wolfram Mittelmeier
Philipp Bergschmidt
Patellar Tracking in Total Knee Arthroplasty—Influence on Clinical and Functional Outcome
Diagnostics
total knee arthroplasty
anterior knee pain
patellar tracking
title Patellar Tracking in Total Knee Arthroplasty—Influence on Clinical and Functional Outcome
title_full Patellar Tracking in Total Knee Arthroplasty—Influence on Clinical and Functional Outcome
title_fullStr Patellar Tracking in Total Knee Arthroplasty—Influence on Clinical and Functional Outcome
title_full_unstemmed Patellar Tracking in Total Knee Arthroplasty—Influence on Clinical and Functional Outcome
title_short Patellar Tracking in Total Knee Arthroplasty—Influence on Clinical and Functional Outcome
title_sort patellar tracking in total knee arthroplasty influence on clinical and functional outcome
topic total knee arthroplasty
anterior knee pain
patellar tracking
url https://www.mdpi.com/2075-4418/12/5/1082
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