Significant reduction of patellar height affected lower clinical outcomes and knee flexion over five-year follow-up after total knee arthroplasty
Aims: This study aimed to investigate the relationship between changes in patellar height and clinical outcomes at a mean follow-up of 7.7 years (5 to 10) after fixed-bearing posterior-stabilized total knee arthroplasty (PS-TKA). Methods: We retrospectively evaluated knee radiographs of 165 knees, w...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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The British Editorial Society of Bone & Joint Surgery
2021-12-01
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| Series: | Bone & Joint Open |
| Subjects: | |
| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.212.BJO-2021-0164.R1 |
| _version_ | 1819097031895941120 |
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| author | Ashish Suthar Kiminori Yukata Yoshikazu Azuma Yutaka Suetomi Kazuhiro Yamazaki Kazushige Seki Takashi Sakai Hiroshi Fujii |
| author_facet | Ashish Suthar Kiminori Yukata Yoshikazu Azuma Yutaka Suetomi Kazuhiro Yamazaki Kazushige Seki Takashi Sakai Hiroshi Fujii |
| author_sort | Ashish Suthar |
| collection | DOAJ |
| description | Aims: This study aimed to investigate the relationship between changes in patellar height and clinical outcomes at a mean follow-up of 7.7 years (5 to 10) after fixed-bearing posterior-stabilized total knee arthroplasty (PS-TKA). Methods: We retrospectively evaluated knee radiographs of 165 knees, which underwent fixed-bearing PS-TKA with patella resurfacing. The incidence of patella baja and changes in patellar height over a minimum of five years of follow-up were determined using Insall-Salvati ratio (ISR) measurement. We examined whether patella baja (ISR < 0.8) at final follow-up affected clinical outcomes, knee joint range of motion (ROM), and Knee Society Score (KSS). We also assessed inter- and intrarater reliability of ISR measurements and focused on the relationship between patellar height reduction beyond measurement error and clinical outcomes. Results: The ISR gradually decreased over five years after TKA, and finally 33 patients (20.0%) had patella baja. Patella baja at the final follow-up was not related to passive knee ROM or KSS. Interestingly, when we divided into two groups - patella baja and patella normal-alta (ISR ≥ 0.8) - the patella baja group already had a lower patellar height before surgery, compared with the patella normal-alta group. The ISR measurement error in this study was 0.17. Both passive knee flexion and KSS were significantly decreased in the group with a decrease in ISR of ≥ 0.17 at final follow-up. Conclusion: Patellar height gradually decreased over five years of follow-up after TKA. The reduction in patellar height beyond measurement error following TKA was associated with lower clinical outcomes. Cite this article: Bone Jt Open 2021;2(12):1075–1081. |
| first_indexed | 2024-12-22T00:08:38Z |
| format | Article |
| id | doaj.art-218d4412a31d40acb3cc7a22e81804d2 |
| institution | Directory Open Access Journal |
| issn | 2633-1462 |
| language | English |
| last_indexed | 2024-12-22T00:08:38Z |
| publishDate | 2021-12-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj.art-218d4412a31d40acb3cc7a22e81804d22022-12-21T18:45:30ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622021-12-012121075108110.1302/2633-1462.212.BJO-2021-0164.R1Significant reduction of patellar height affected lower clinical outcomes and knee flexion over five-year follow-up after total knee arthroplastyAshish Suthar0Kiminori Yukata1Yoshikazu Azuma2Yutaka Suetomi3Kazuhiro Yamazaki4Kazushige Seki5Takashi Sakai6Hiroshi Fujii7Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Yamaguchi, JapanDepartment of Orthopedic Surgery, Ogori Daiichi General Hospital, Yamaguchi, JapanDepartment of Orthopedic Surgery, Ogori Daiichi General Hospital, Yamaguchi, JapanDepartment of Orthopedic Surgery, Ogori Daiichi General Hospital, Yamaguchi, JapanDepartment of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, JapanDepartment of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, JapanDepartment of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, JapanDepartment of Orthopedic Surgery, Ogori Daiichi General Hospital, Yamaguchi, JapanAims: This study aimed to investigate the relationship between changes in patellar height and clinical outcomes at a mean follow-up of 7.7 years (5 to 10) after fixed-bearing posterior-stabilized total knee arthroplasty (PS-TKA). Methods: We retrospectively evaluated knee radiographs of 165 knees, which underwent fixed-bearing PS-TKA with patella resurfacing. The incidence of patella baja and changes in patellar height over a minimum of five years of follow-up were determined using Insall-Salvati ratio (ISR) measurement. We examined whether patella baja (ISR < 0.8) at final follow-up affected clinical outcomes, knee joint range of motion (ROM), and Knee Society Score (KSS). We also assessed inter- and intrarater reliability of ISR measurements and focused on the relationship between patellar height reduction beyond measurement error and clinical outcomes. Results: The ISR gradually decreased over five years after TKA, and finally 33 patients (20.0%) had patella baja. Patella baja at the final follow-up was not related to passive knee ROM or KSS. Interestingly, when we divided into two groups - patella baja and patella normal-alta (ISR ≥ 0.8) - the patella baja group already had a lower patellar height before surgery, compared with the patella normal-alta group. The ISR measurement error in this study was 0.17. Both passive knee flexion and KSS were significantly decreased in the group with a decrease in ISR of ≥ 0.17 at final follow-up. Conclusion: Patellar height gradually decreased over five years of follow-up after TKA. The reduction in patellar height beyond measurement error following TKA was associated with lower clinical outcomes. Cite this article: Bone Jt Open 2021;2(12):1075–1081.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.212.BJO-2021-0164.R1insall-salvati ratiopatella bajapatellar heightpatellar tendon shorteningtotal knee arthroplastyclinical outcomespatellar heightknee in flexiontotal knee arthroplasty (tka)kneespatella bajapatellaknee society scoreradiographsposterior-stabilized total knee arthroplasty |
| spellingShingle | Ashish Suthar Kiminori Yukata Yoshikazu Azuma Yutaka Suetomi Kazuhiro Yamazaki Kazushige Seki Takashi Sakai Hiroshi Fujii Significant reduction of patellar height affected lower clinical outcomes and knee flexion over five-year follow-up after total knee arthroplasty Bone & Joint Open insall-salvati ratio patella baja patellar height patellar tendon shortening total knee arthroplasty clinical outcomes patellar height knee in flexion total knee arthroplasty (tka) knees patella baja patella knee society score radiographs posterior-stabilized total knee arthroplasty |
| title | Significant reduction of patellar height affected lower clinical outcomes and knee flexion over five-year follow-up after total knee arthroplasty |
| title_full | Significant reduction of patellar height affected lower clinical outcomes and knee flexion over five-year follow-up after total knee arthroplasty |
| title_fullStr | Significant reduction of patellar height affected lower clinical outcomes and knee flexion over five-year follow-up after total knee arthroplasty |
| title_full_unstemmed | Significant reduction of patellar height affected lower clinical outcomes and knee flexion over five-year follow-up after total knee arthroplasty |
| title_short | Significant reduction of patellar height affected lower clinical outcomes and knee flexion over five-year follow-up after total knee arthroplasty |
| title_sort | significant reduction of patellar height affected lower clinical outcomes and knee flexion over five year follow up after total knee arthroplasty |
| topic | insall-salvati ratio patella baja patellar height patellar tendon shortening total knee arthroplasty clinical outcomes patellar height knee in flexion total knee arthroplasty (tka) knees patella baja patella knee society score radiographs posterior-stabilized total knee arthroplasty |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.212.BJO-2021-0164.R1 |
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