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General Orthopaedics

RESTORATION OF PATELLOFEMORAL KINEMATICS WITH AN ANATOMICAL PATELLA DESIGN: A PROSPECTIVE MATCHED-PAIR ANALYSIS

The International Society for Technology in Arthroplasty (ISTA), 27th Annual Congress. PART 3.



Abstract

Introduction

Potential implant and technique related factors to improve patellofemoral (PF) kinematics in total knee arthroplasty (TKA) are design of trochlear geometry and patella, restoration of posterior offset, patellar tilt and avoid overstuffing. The primary aim of this prospective, matched pair study was to assess the radiographic features of PF kinematics with an anatomic patella.

Material and Methods

Between July 2012 and May 2013, 49 consecutive posterior stabilized cemented Attune TKAs (Depuy Synthes Warsaw Indiana) were matched to the 49 PFC Sigma (Depuy) based on age, gender, and body mass index (BMI). All surgeries were performed via medial parapatellar approach with patellar resurfacing. Radiographic analysis was performed prospectively with minimum 1-year follow-up and included overall limb alignment, anterior offset, posterior offset, joint line, patellar thickness, patellar tilt and patellar displacement by two independent observers.

Results

We found significant improvement in all post-operative radiographies parameters from prior to surgery, however, there was no significance between the two groups (Table 1). Posterior offset and joint line were restored in all cases and no overstuffing of the PF joint was seen.

Discussion

At minimum one-year follow-up, anatomical patella has excellent safety and efficacy with restoration of the PF kinematics. Metalized design of the Attune anatomic patella component allows better contact with trochlear groove and improves tilt with lateralization of the patella.


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