ArticleInternational orthopaedics2018
The predictive factors of secondary patellar resurfacing in computer-assisted total knee arthroplasty. A prospective cohort study.
Article in International orthopaedics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 11 citations in OpenAlex.
- No difference between resurfaced and non-resurfaced patellae with a modern prosthesis design: a prospective randomized study of 250 total knee arthroplasties.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Trial
- Resurfacing versus not-resurfacing the patella in one-stage bilateral total knee arthroplasty: a prospective randomized clinical trial.International orthopaedics · 2019Trial
- Similar secondary patellar resurfacing but higher tibial revision risk with posterior stabilized versus medial pivot total knee arthroplasty: A registry analysis.Journal of experimental orthopaedics · 2026Article
- No difference in revision rate in patella-friendly total knee arthroplasty with or without patella resurfacing at 5 years' follow-up. A database analysis.Journal of experimental orthopaedics · 2025Article
- The influence of patellar morphology on clinical outcomes after unicompartmental knee arthroplasty.International orthopaedics · 2024Article
- Global mapping of institutional and hospital-based (Level II-IV) arthroplasty registries: a scoping review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Patellar facet ratio affects knee pain, stair climbing and stair descent after TKA without patellar resurfacing.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Conventional versus computer-assisted surgery in total knee arthroplasty: comparison at ten years follow-up.International orthopaedics · 2019Article
- Predictors for secondary patellar resurfacing after primary total knee arthroplasty using a "patella-friendly" total knee arthroplasty system.International orthopaedics · 2019Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe decision to resurface the patella during total knee arthroplasty (TKA) remains controversial. This prospective cohort study aimed to evaluate the outcome and survivorship of the native patella in computer-assisted TKA (CAS TKA) implanted for primary knee osteoarthritis, and to determine the predictive factors of secondary patellar resurfacing (SPR).
methodsA prospective cohort of 273 cementless ultra-congruent mobile-bearing CAS TKA implanted without patellar resurfacing was included in our total joint registry. Patients were evaluated with the International Knee Society (IKS) and Hospital for Special Surgery Patellar (HSSP) scores. Radiographic evaluation was focused on the patellofemoral (PF) compartment to assess: the patellar dysplasia (Wiberg classification), PF osteoarthritis (Iwano classification), femoral trochlear dysplasia (femoral sulcus angle), patellar maltracking (patellar tilt and lateralization), and patella height (Blackburne-Peel ratio).
resultsAt a six-year median follow-up, the CAS TKA survivorship using SPR as end-point was 95% (range, 91-99%). The IKS and HSSP improved significantly after SPR (p = 0.001 and 0.004, respectively). No significant difference in the IKS and HSSP was detected between TKA with native patella and SPR-TKA at latest follow-up. Importantly, four pre-operative radiographic PF parameters were significantly associated with SPR: higher stages of patellar dysplasia and PF osteoarthritis, and higher sulcus angle and patellar lateralization (hazard ratios = 5.1 to 11.6, p = 0.009 to 0.04).
conclusionWhen preserving the native patella, surgeons should be aware of pre-operative PF radiographic parameters that could influence the outcome and survivorship of CAS TKA leading to SPR. Particularly, evidence of PF dysplasia, osteoarthritis and maltracking should be determined pre-operatively to resurface the patella at the time of TKA. LEVEL OF EVIDENCE: Therapeutic Level II (prospective cohort study).
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