ArticleJournal of experimental orthopaedics2026
Sagittal alignment changes predict patellar osteosclerosis after total knee arthroplasty without resurfacing.
Article in Journal of experimental orthopaedics, 2026. 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
Purpose: Total knee arthroplasty (TKA) is an effective treatment for knee osteoarthritis; however, some patients experience post-operative anterior knee pain related to patellofemoral (PF) loading. Subchondral patellar osteosclerosis on radiographs may indirectly reflect increased PF stress. This study examined whether changes in posterior tibial slope (PTS) and femorotibial posterior overhang (FTPO) are associated with patellar osteosclerosis after TKA without patellar resurfacing. Methods: A total of 94 knees (71 patients) that underwent TKA without patellar resurfacing for medial OA using the Journey II Bi-Cruciate Stabilized (BCS) system were retrospectively reviewed. Knees were classified according to the presence of post-operative patellar osteosclerosis. Group differences were evaluated using the Mann-Whitney Results: Patellar osteosclerosis developed in 26 out of 94 knees (27.7%). The osteosclerosis group showed significantly greater post-operative reductions in both PTS and FTPO ( Conclusion: Post-operative reductions in PTS and relative femoral anteriorization were associated with patellar osteosclerosis after TKA without patellar resurfacing. These sagittal alignment changes may contribute to increased PF joint stress and anterior knee pain. Although PF pressure and symptoms were not directly evaluated, avoiding excessive PTS reduction and femoral anteriorization may help minimize PF overloading. Level of Evidence: Level III.
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