학술논문

No difference in 1-year improvement of patient-reported physical functioning and pain between resurfaced and unresurfaced patellae: analysis of 17,224 primary total knee arthroplasties in the Dutch Arthroplasty Register.
Document Type
Article
Source
Acta Orthopaedica. 2023, Vol. 94, p274-279. 6p.
Subject
*REPORTING of diseases
*TOTAL knee replacement
*PATELLA
*CONFIDENCE intervals
*SCIENTIFIC observation
*FUNCTIONAL status
*HEALTH outcome assessment
*REGRESSION analysis
*DESCRIPTIVE statistics
*POSTOPERATIVE pain
Language
ISSN
1745-3674
Abstract
Background and purpose -- Whether or not to resurface the patella during primary total knee arthroplasty (TKA) remains controversial. We aimed to investigate the association between patellar resurfacing and patient-reported outcome measure (PROM) improvement 1 year postoperatively in terms of physical functioning and pain following TKA. Patients and methods -- We performed an observational study using the Dutch Arthroplasty Register on prospectively collected PROM data (n = 17,224, years 2014-2019). Preoperative and 1-year PROM pain scores (NRS at rest; during activity) and physical functioning scores (KOOS-PS, OKS) were examined. Stratification was performed for cruciate-retaining (CR) and posterior-stabilized (PS) and for the 4 most frequently used TKA implants in the Netherlands (Nexgen, Genesis II, PFC/Sigma, Vanguard) using multivariable linear regression adjusting for age, ASA classification, preoperative general health (EQ VAS), and preoperative PROMs. Results -- 4,525 resurfaced and 12,699 unresurfaced patellae in TKA were analyzed. Overall, no significant difference in 1-year PROM improvement was found between the 2 groups. In CR TKAs, resurfacing resulted in less improvement in KOOS-PS and OKS (adjusted difference between groups (B) -1.68, 95% confidence interval (CI) -2.86 to -0.50 and B -0.94, CI -1.57 to -0.31. Fewer improvements for patellar resurfacing in TKA were found for the Genesis TKA on NRS pain at rest (B -0.23, CI-0.40 to -0.06) and Oxford knee score (B -1.61, CI -2.24 to -0.98). Conclusion -- No significant differences were found in 1-year improvement of physical functioning and pain between TKA with resurfaced and unresurfaced patellae. [ABSTRACT FROM AUTHOR]