Reduction of Patella-baja and Pseudo-patella-baja Does Not Improve Range of Motion in Patients After Mega-TKA

矫正髌骨低位和假性髌骨低位并不能改善接受大型全膝关节置换术患者的关节活动范围。

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Abstract

BACKGROUND/AIM: Patella baja (PB) and pseudo-patella baja (PPB) have been shown to negatively influence outcomes after total knee arthroplasty. We hypothesized that there is a high incidence of PB and PPB after megaprosthetic total knee arthroplasty (M-TKA), and that this is associated with reduced range of motion. PATIENTS AND METHODS: We retrospectively analysed all patients in our Orthopaedic Trauma Department after distal femur or proximal tibia replacement. Preoperative and one-year postoperative follow-up included measurement of range of motion and detection of PB and PPB using radiological indices. RESULTS: We included 44 patients (age: 73±19 years). Preoperative PB detected by ISI could be reduced from 13 (36%) to 11 (25%) (p<0.01). Preoperative vs. postoperative ISI was 0.88±0.23 vs. 1.06±0.45 (p=0.03). PPB was observed preoperatively in 23 (63%) patients vs. 24 (54%) postoperatively. Preoperative vs. postoperative CDI was 0.70±0.24 vs. 0.95±0.43 (p=0.002). Preoperative flexion was 91°±30° vs. 85°±24° postoperatively (p>0.05). CONCLUSION: Both PB and PPB are frequently observed after M-TKA. A reduction in PB and PPB alone does not improve postoperative range of motion.

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