Does Patellar Resurfacing Matter? Midterm Follow-Up of MRK Total Knee Replacement
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ORIGINAL ARTICLE
Does Patellar Resurfacing Matter? Midterm Follow‑Up of MRK Total Knee Replacement Dhrumin Sangoi1 · Nikhil Gokhale1 · Sanat Kulkarni2 · Preetham Kodumuri3 · Paresh Kothari1 · Sushrut Kulkarni1 Received: 10 July 2020 / Accepted: 7 September 2020 © Indian Orthopaedics Association 2020
Abstract Background Many designs of TKR have been developed to optimize the kinematics and improve satisfaction, including the ‘medial rotating’ philosophy. The purpose of this study is to report the mid-term clinical outcome of MRK knees and evaluate whether resurfacing the patella makes any difference in outcome. Methods A retrospective analysis was done of 104 MRK total knee replacement done between 2008 and 2017. Patients were called for a review for evaluation of OKS, Baldini and Feller scores. Demographics of the patients, clinical outcome, complications were assessed. Results 62 had patellar resurfacing. Mean follow-up was 74.45 months in non- resurfaced and 54.93 months in resurfaced group. Mean flexion range in both groups at final follow-up was 101.45. Median OKS at follow-up was 36 (12–47) in non-resurfaced and 37 (9–48) in resurfaced group. Patella scores were better in resurfaced group—Baldini score median (range) was 90 (25–100) in non-resurfaced v/s 100 (30–100) in resurfaced, Feller score median (range) was 25 (12–30) in non-resurfaced v/s 28 (10–30) (p 0.042) in resurfaced. The patellofemoral component of the OKS (Q5 + Q7 + Q12) median showed an improvement from 3 (1–11) to 6.5 (3–11) in non-resurfaced and from 3 (0–12) to 8 (2–12) (p 0.039) in resurfaced group. There were five complications overall (4.8%). Conclusion These results show a satisfactory outcome at mid-term follow-up. We found a statistically significant difference in Feller score and in the patellofemoral component of OKS between the groups of MRK knee suggesting specific benefits of patellar resurfacing with this implant. Keywords MRK knee replacement · Medial rotation · Patella resurfacing · Clinical outcome
Introduction Total knee arthroplasty is a very routinely performed surgery now-a-days for end stage arthritis. Over the period of 2003 to 2016, a total of 975,739 knee joints were replaced for the first time (primary joint replacement) in United Kingdom. [1] The National Joint Registry (NJR) for England, Wales
* Dhrumin Sangoi [email protected] 1
Trauma and Orthopaedic Department, Kingsmill Hospital, Sherwood Forest Hospital NHS Trust, Mansfield Road, Sutton‑in‑Ashfield NG17 4JL, UK
2
Medical School, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
3
Wrexham Maelor Hospital, Croesnewydd Road, Wrexham LL13 7TD, UK
and Northern Ireland reports that approximately 90,000 TKAs are performed annually. PCL substituting knee arthroplasty have shown more predictable knee kinematics than PCL retaining knees [2–4]. However, there is still concern over wear occurring in campost mechanism in fixed-bearing prosthesis [5, 6] sparking interest in mobile bearing prosthesis. Among the design alternatives to
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