ArticleArchives of orthopaedic and trauma surgery2024
Frequent complications of deficient patellae after component removal in 1.5-stage exchange arthroplasty for periprosthetic joint infection.
Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo compare the complication rates between deficient patellae (remnant patellae after component removal) and non-resurfaced patellae after 1.5-stage exchange arthroplasty for periprosthetic joint infection and identify risk factors for complications of deficient patellae.
methodsComplications in 76 deficient patellae (group D) and 41 non-resurfaced patellae (group N), with a minimum follow-up of 2 years after 1.5-stage exchange arthroplasty were retrospectively analyzed. Demographic characteristics and mean follow-up period did not differ between the groups. The incidences of patellar maltracking, erosion, and fractures were investigated. Factors affecting each patellar complication in group D were investigated in terms of age, sex, body mass index, postoperative hip-knee-ankle angle (HKA), remnant patellar thickness, and change in joint line height.
resultsThe incidence of patellar maltracking and erosion was significantly higher in group D than in group N [maltracking: 16 (21.1%) vs. 0 cases (0%), p = 0.001; erosion: 30 (39.5%) vs. 2 cases (4.9%), p < 0.001]. The incidence of patellar fractures tended to be higher in group D [6 (7.8%) vs. 0 cases, p = 0.090]. In group D, postoperative valgus limb alignment and younger age were identified as significant factors that affected patellar maltracking (odds ratio of postoperative HKA = 1.628, p = 0.005) and erosion (odds ratio of age = 0.909, p = 0.009), respectively.
conclusionClose observation of the complications of deficient patellae is required after 1.5-stage exchange arthroplasty. Valgus limb alignment should be avoided to reduce the risk of complications. Early second-stage revision with patellar reconstruction can be considered in younger patients with deficient patellae. LEVEL OF EVIDENCE: III.
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