Higher failure rate of secondary patellar resurfacing following bicompartmental knee arthroplasty

doi:10.1007/s00402-023-04924-9

. 2023 Oct;143(10):6315-6321.

doi: 10.1007/s00402-023-04924-9. Epub 2023 Jun 1.

Higher failure rate of secondary patellar resurfacing following bicompartmental knee arthroplasty

Francesco Pardo¹, Federico Giardina¹, Cristina Ancarani², Barbara Bordini², Francesco Castagnini³, Francesco Perdisa⁴, Francesco Traina^{1

5}

Affiliations

¹ Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
² Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy.
³ Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy. francescocastagnini@hotmail.it.
⁴ Villa Erbosa Hospital, Gruppo San Donato, Bologna, Italy.
⁵ Orthopaedics and Traumatology, DIBINEM, University of Bologna, Bologna, Italy.

PMID: 37261480
DOI: 10.1007/s00402-023-04924-9

Higher failure rate of secondary patellar resurfacing following bicompartmental knee arthroplasty

Francesco Pardo et al. Arch Orthop Trauma Surg. 2023 Oct.

. 2023 Oct;143(10):6315-6321.

doi: 10.1007/s00402-023-04924-9. Epub 2023 Jun 1.

Authors

Francesco Pardo¹, Federico Giardina¹, Cristina Ancarani², Barbara Bordini², Francesco Castagnini³, Francesco Perdisa⁴, Francesco Traina^{1

5}

Affiliations

¹ Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
² Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy.
³ Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy. francescocastagnini@hotmail.it.
⁴ Villa Erbosa Hospital, Gruppo San Donato, Bologna, Italy.
⁵ Orthopaedics and Traumatology, DIBINEM, University of Bologna, Bologna, Italy.

PMID: 37261480
DOI: 10.1007/s00402-023-04924-9

Abstract

Introduction: The role of secondary patellar resurfacing (SPR) in anterior knee pain (AKP) is still debated in literature. A regional arthroplasty registry was investigated, aiming to: (1) assess the survival rate of SPR; and (2) compare SPR to tricompartmental TKA.

Materials and methods: The regional arthroplasty registry RIPO was investigated about all SPRs performed after bicompartmental arthroplasty. The survival rates and the reasons for revision were assessed as any other factor that could have influenced implants failure. SPR survivorship was compared to tricompartmental TKAs.

Results: 406 SPRs performed after bicompartmental arthroplasty were analyzed. The survival rates were 80.6% (CI 95% 75.9-84.5) at 5 years and 77.6% (CI 95% 72.4-82) at 7 years. Half of the SPRs was performed 0.9-2.4 years after the index bicompartmental arthroplasty. SPR achieved lower survival than tricompartmental TKA (80.6% vs 96.7%, p < 0.001), with an adjusted hazard ratio for failure of 5.5 (CI 95% 4.2-7.1, p < 0.001). SPRs performed within 2 years after primary implant had a significantly higher rates of failure when compared to tricompartmental TKA (HR: 6.4, CI 95% 4.8-8.4, p < 0.001).

Conclusion: SPR after bicompartmental knee arthroplasty showed modest 5- and 7-year survival rates, worse than primary tricompartmental TKA. When SPRs are performed within 2 years after primary arthroplasty, a significant higher risk of failure should be expected, highlighting than appropriate pre-operative work-up and patient selection is crucial for SPR successful outcome.

Level of evidence: III, therapeutic study.

Keywords: Anterior knee pain; Patellar resurfacing; Patellar retention; Total knee replacement.

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References

1. Coory JA, Tan KG, Whitehouse SL, Hatton A, Graves SE, Crawford RW (2020) The outcome of total knee arthroplasty with and without patellar resurfacing up to 17 years: a report From the Australian Orthopaedic Association National Joint Replacement Registry. J Arthroplasty 35(1):132–138. https://doi.org/10.1016/j.arth.2019.08.007 - DOI - PubMed
1. Fraser JF, Spangehl MJ (2017) International rates of patellar resurfacing in primary total knee arthroplasty, 2004–2014. J Arthroplasty 32:83–86. https://doi.org/10.1016/j.arth.2016.06.010 - DOI - PubMed
1. Grassi A, Compagnoni R, Ferrua P, Zaffagnini S, Berruto M, Samuelsson K et al (2018) Patellar resurfacing versus patellar retention in primary total knee arthroplasty: a systematic review of overlapping meta-analyses. Knee Surg Sport Traumatol Arthrosc 26:3206–3218. https://doi.org/10.1007/s00167-018-4831-8 - DOI
1. Migliorini F, Eschweiler J, Niewiera M, El Mansy Y, Tingart M, Rath B (2019) Better outcomes with patellar resurfacing during primary total knee arthroplasty: a meta-analysis study. Arch Orthop Trauma Surg 139:1445–1454. https://doi.org/10.1007/s00402-019-03246-z - DOI - PubMed
1. Duan G, Liu C, Lin W, Shao J, Fu K, Niu Y et al (2018) Different factors conduct anterior knee pain following primary total knee arthroplasty: a systematic review and meta-analysis. J Arthroplasty 33:1962-1971.e3. https://doi.org/10.1016/j.arth.2017.12.024 - DOI - PubMed

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[1] Coory JA, Tan KG, Whitehouse SL, Hatton A, Graves SE, Crawford RW (2020) The outcome of total knee arthroplasty with and without patellar resurfacing up to 17 years: a report From the Australian Orthopaedic Association National Joint Replacement Registry. J Arthroplasty 35(1):132–138. https://doi.org/10.1016/j.arth.2019.08.007 - DOI - PubMed

[2] Coory JA, Tan KG, Whitehouse SL, Hatton A, Graves SE, Crawford RW (2020) The outcome of total knee arthroplasty with and without patellar resurfacing up to 17 years: a report From the Australian Orthopaedic Association National Joint Replacement Registry. J Arthroplasty 35(1):132–138. https://doi.org/10.1016/j.arth.2019.08.007 - DOI - PubMed

[3] Fraser JF, Spangehl MJ (2017) International rates of patellar resurfacing in primary total knee arthroplasty, 2004–2014. J Arthroplasty 32:83–86. https://doi.org/10.1016/j.arth.2016.06.010 - DOI - PubMed

[4] Fraser JF, Spangehl MJ (2017) International rates of patellar resurfacing in primary total knee arthroplasty, 2004–2014. J Arthroplasty 32:83–86. https://doi.org/10.1016/j.arth.2016.06.010 - DOI - PubMed

[5] Grassi A, Compagnoni R, Ferrua P, Zaffagnini S, Berruto M, Samuelsson K et al (2018) Patellar resurfacing versus patellar retention in primary total knee arthroplasty: a systematic review of overlapping meta-analyses. Knee Surg Sport Traumatol Arthrosc 26:3206–3218. https://doi.org/10.1007/s00167-018-4831-8 - DOI

[6] Grassi A, Compagnoni R, Ferrua P, Zaffagnini S, Berruto M, Samuelsson K et al (2018) Patellar resurfacing versus patellar retention in primary total knee arthroplasty: a systematic review of overlapping meta-analyses. Knee Surg Sport Traumatol Arthrosc 26:3206–3218. https://doi.org/10.1007/s00167-018-4831-8 - DOI

[7] Migliorini F, Eschweiler J, Niewiera M, El Mansy Y, Tingart M, Rath B (2019) Better outcomes with patellar resurfacing during primary total knee arthroplasty: a meta-analysis study. Arch Orthop Trauma Surg 139:1445–1454. https://doi.org/10.1007/s00402-019-03246-z - DOI - PubMed

[8] Migliorini F, Eschweiler J, Niewiera M, El Mansy Y, Tingart M, Rath B (2019) Better outcomes with patellar resurfacing during primary total knee arthroplasty: a meta-analysis study. Arch Orthop Trauma Surg 139:1445–1454. https://doi.org/10.1007/s00402-019-03246-z - DOI - PubMed

[9] Duan G, Liu C, Lin W, Shao J, Fu K, Niu Y et al (2018) Different factors conduct anterior knee pain following primary total knee arthroplasty: a systematic review and meta-analysis. J Arthroplasty 33:1962-1971.e3. https://doi.org/10.1016/j.arth.2017.12.024 - DOI - PubMed

[10] Duan G, Liu C, Lin W, Shao J, Fu K, Niu Y et al (2018) Different factors conduct anterior knee pain following primary total knee arthroplasty: a systematic review and meta-analysis. J Arthroplasty 33:1962-1971.e3. https://doi.org/10.1016/j.arth.2017.12.024 - DOI - PubMed

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Higher failure rate of secondary patellar resurfacing following bicompartmental knee arthroplasty

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Higher failure rate of secondary patellar resurfacing following bicompartmental knee arthroplasty

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