Incidence of patella baja and pseudopatella baja in aseptic revision total knee arthroplasty
Introduction There are two variants regarding the low location of the patella in relation to the tibio-femoral joint line: patella baja (PB) and pseudo-patella baja (PPB). The purpose of this study is to investigate the incidence of PB and PPB in a cohort of patients that underwent revision total kn...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2024-04, Vol.144 (4), p.1703-1712 |
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| creator | Flevas, Dimitrios A. Brenneis, Marco Nocon, Allina Gkiatas, Ioannis Pirzada, Wali Tsakotos, Georgios Sculco, Peter K. |
| description | Introduction
There are two variants regarding the low location of the patella in relation to the tibio-femoral joint line: patella baja (PB) and pseudo-patella baja (PPB). The purpose of this study is to investigate the incidence of PB and PPB in a cohort of patients that underwent revision total knee arthroplasty (rTKA) for aseptic reasons and describe any differences in each group’s ROM.
Methods
This retrospective study included 114 patients that underwent aseptic revision TKA surgery between 2017 and 2022. Patients were revised either for stiffness (Group 1) or aseptic loosening/instability (Group 2). The Insall-Salvati ratio (ISR) and Blackburne-Peel ratio (BPR) were used to evaluate the patellar position. ISR |
| doi_str_mv | 10.1007/s00402-024-05234-4 |
| format | Article |
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There are two variants regarding the low location of the patella in relation to the tibio-femoral joint line: patella baja (PB) and pseudo-patella baja (PPB). The purpose of this study is to investigate the incidence of PB and PPB in a cohort of patients that underwent revision total knee arthroplasty (rTKA) for aseptic reasons and describe any differences in each group’s ROM.
Methods
This retrospective study included 114 patients that underwent aseptic revision TKA surgery between 2017 and 2022. Patients were revised either for stiffness (Group 1) or aseptic loosening/instability (Group 2). The Insall-Salvati ratio (ISR) and Blackburne-Peel ratio (BPR) were used to evaluate the patellar position. ISR < 0.8 defined PB, while cases with ISR ≥ 0.8 and BPI < 0.54 were defined as PPB. ROM was measured and a subanalysis was conducted to investigate the progression of the values of ISR and BPR.
Results
55 patients comprised Group 1, and 59 patients comprised Group 2. Overall, 13 cases (11.4%) had PB before rTKA and 24 (21%) had PB after rTKA. Cases with PPB were 13 (11.4%) before and 34 (29.9%) after rTKA. Group 1 patients presented with more PB before and after rTKA (12.8% vs 10.2% and 27.3% vs 15.2% respectively). However, after rTKA Group 1 patients presented with less PPB (20%) compared to Group 2 (39%) (p = 0.02). In Group 1, patients with PPB after rTKA had less ROM compared to those without PPB [83.2 (± 21.9) vs 102.1 (± 19.9) (p = 0.025)]. The subanalysis (69 patients) showed a statistically significant decrease in ISR before and after rTKA (p = 0.041), and from the native knee to post-rTKA (p = 0.001). There was a statistically significant decrease in BPR before and after rTKA (p = 0.001) and from the native knee to both pre- and post-rTKA (p < 001).
Conclusion
After undergoing rTKA, the incidences of both patella baja (PB) and pseudo-patella baja (PPB) increased. Stiffness in the knee was associated with a higher incidence of PB, while non-stiffness cases showed a significantly higher incidence of PPB. Patients with stiff knees and PPB after rTKA experienced a significant reduction in range of motion (ROM). Additionally, the study revealed a noteworthy decrease in ISR and BPR with each subsequent surgery. This information is crucial for healthcare providers, as it sheds light on potential risks and outcomes of rTKA, allowing for improved patient management and surgical decision-making.
Level of evidence
III.</description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-024-05234-4</identifier><identifier>PMID: 38488903</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Arthroplasty, Replacement, Knee - adverse effects ; Humans ; Incidence ; Joint Diseases - surgery ; Joint replacement surgery ; Knee ; Knee Joint - surgery ; Knee Prosthesis - adverse effects ; Knee Revision Surgery ; Medicine ; Medicine & Public Health ; Orthopedics ; Patella - surgery ; Range of Motion, Articular ; Retrospective Studies</subject><ispartof>Archives of orthopaedic and trauma surgery, 2024-04, Vol.144 (4), p.1703-1712</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-3c33f31d06800085f8dd7dead282b7ab551c8bfdfe7ff1d00ea1202d0c0cd9593</cites><orcidid>0000-0002-9997-4846</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-024-05234-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-024-05234-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38488903$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Flevas, Dimitrios A.</creatorcontrib><creatorcontrib>Brenneis, Marco</creatorcontrib><creatorcontrib>Nocon, Allina</creatorcontrib><creatorcontrib>Gkiatas, Ioannis</creatorcontrib><creatorcontrib>Pirzada, Wali</creatorcontrib><creatorcontrib>Tsakotos, Georgios</creatorcontrib><creatorcontrib>Sculco, Peter K.</creatorcontrib><creatorcontrib>TKAF Consortium</creatorcontrib><title>Incidence of patella baja and pseudopatella baja in aseptic revision total knee arthroplasty</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
There are two variants regarding the low location of the patella in relation to the tibio-femoral joint line: patella baja (PB) and pseudo-patella baja (PPB). The purpose of this study is to investigate the incidence of PB and PPB in a cohort of patients that underwent revision total knee arthroplasty (rTKA) for aseptic reasons and describe any differences in each group’s ROM.
Methods
This retrospective study included 114 patients that underwent aseptic revision TKA surgery between 2017 and 2022. Patients were revised either for stiffness (Group 1) or aseptic loosening/instability (Group 2). The Insall-Salvati ratio (ISR) and Blackburne-Peel ratio (BPR) were used to evaluate the patellar position. ISR < 0.8 defined PB, while cases with ISR ≥ 0.8 and BPI < 0.54 were defined as PPB. ROM was measured and a subanalysis was conducted to investigate the progression of the values of ISR and BPR.
Results
55 patients comprised Group 1, and 59 patients comprised Group 2. Overall, 13 cases (11.4%) had PB before rTKA and 24 (21%) had PB after rTKA. Cases with PPB were 13 (11.4%) before and 34 (29.9%) after rTKA. Group 1 patients presented with more PB before and after rTKA (12.8% vs 10.2% and 27.3% vs 15.2% respectively). However, after rTKA Group 1 patients presented with less PPB (20%) compared to Group 2 (39%) (p = 0.02). In Group 1, patients with PPB after rTKA had less ROM compared to those without PPB [83.2 (± 21.9) vs 102.1 (± 19.9) (p = 0.025)]. The subanalysis (69 patients) showed a statistically significant decrease in ISR before and after rTKA (p = 0.041), and from the native knee to post-rTKA (p = 0.001). There was a statistically significant decrease in BPR before and after rTKA (p = 0.001) and from the native knee to both pre- and post-rTKA (p < 001).
Conclusion
After undergoing rTKA, the incidences of both patella baja (PB) and pseudo-patella baja (PPB) increased. Stiffness in the knee was associated with a higher incidence of PB, while non-stiffness cases showed a significantly higher incidence of PPB. Patients with stiff knees and PPB after rTKA experienced a significant reduction in range of motion (ROM). Additionally, the study revealed a noteworthy decrease in ISR and BPR with each subsequent surgery. This information is crucial for healthcare providers, as it sheds light on potential risks and outcomes of rTKA, allowing for improved patient management and surgical decision-making.
Level of evidence
III.</description><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Humans</subject><subject>Incidence</subject><subject>Joint Diseases - surgery</subject><subject>Joint replacement surgery</subject><subject>Knee</subject><subject>Knee Joint - surgery</subject><subject>Knee Prosthesis - adverse effects</subject><subject>Knee Revision Surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Patella - surgery</subject><subject>Range of Motion, Articular</subject><subject>Retrospective Studies</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1O3DAURq2qiBmmvACLylI3bALXdn6cJUItII3UDd1Vshz7GjLN2KmdIPH29XQoUBas_Mk-9_PVIeSEwRkDaM4TQAm8AF4WUHFRFuUHsmRlDqJl9cdXeUGOUtoAMC5bOCQLIUuZk1iSnzfe9Ba9QRocHfWEw6Bppzeaam_pmHC24b_r3lOdcJx6QyM-9KkPnk5h0gP95RGpjtN9DOOg0_T4iRw4PSQ8fjpX5Me3r7eX18X6-9XN5cW6MILXUyGMEE4wC7UEAFk5aW1jUVsuedforqqYkZ2zDhvnMgaoGQduwYCxbdWKFTnd944x_J4xTWrbJ7Nb2WOYk-JtJXkra8Yy-uUNuglz9Hk7tSOaBkRdZorvKRNDShGdGmO_1fFRMVA792rvXmX36q97tRv6_FQ9d1u0zyP_ZGdA7IGUn_wdxpe_36n9A6Pkj3k</recordid><startdate>20240401</startdate><enddate>20240401</enddate><creator>Flevas, Dimitrios A.</creator><creator>Brenneis, Marco</creator><creator>Nocon, Allina</creator><creator>Gkiatas, Ioannis</creator><creator>Pirzada, Wali</creator><creator>Tsakotos, Georgios</creator><creator>Sculco, Peter K.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9997-4846</orcidid></search><sort><creationdate>20240401</creationdate><title>Incidence of patella baja and pseudopatella baja in aseptic revision total knee arthroplasty</title><author>Flevas, Dimitrios A. ; Brenneis, Marco ; Nocon, Allina ; Gkiatas, Ioannis ; Pirzada, Wali ; Tsakotos, Georgios ; Sculco, Peter K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-3c33f31d06800085f8dd7dead282b7ab551c8bfdfe7ff1d00ea1202d0c0cd9593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Humans</topic><topic>Incidence</topic><topic>Joint Diseases - surgery</topic><topic>Joint replacement surgery</topic><topic>Knee</topic><topic>Knee Joint - surgery</topic><topic>Knee Prosthesis - adverse effects</topic><topic>Knee Revision Surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Patella - surgery</topic><topic>Range of Motion, Articular</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Flevas, Dimitrios A.</creatorcontrib><creatorcontrib>Brenneis, Marco</creatorcontrib><creatorcontrib>Nocon, Allina</creatorcontrib><creatorcontrib>Gkiatas, Ioannis</creatorcontrib><creatorcontrib>Pirzada, Wali</creatorcontrib><creatorcontrib>Tsakotos, Georgios</creatorcontrib><creatorcontrib>Sculco, Peter K.</creatorcontrib><creatorcontrib>TKAF Consortium</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Flevas, Dimitrios A.</au><au>Brenneis, Marco</au><au>Nocon, Allina</au><au>Gkiatas, Ioannis</au><au>Pirzada, Wali</au><au>Tsakotos, Georgios</au><au>Sculco, Peter K.</au><aucorp>TKAF Consortium</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence of patella baja and pseudopatella baja in aseptic revision total knee arthroplasty</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2024-04-01</date><risdate>2024</risdate><volume>144</volume><issue>4</issue><spage>1703</spage><epage>1712</epage><pages>1703-1712</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
There are two variants regarding the low location of the patella in relation to the tibio-femoral joint line: patella baja (PB) and pseudo-patella baja (PPB). The purpose of this study is to investigate the incidence of PB and PPB in a cohort of patients that underwent revision total knee arthroplasty (rTKA) for aseptic reasons and describe any differences in each group’s ROM.
Methods
This retrospective study included 114 patients that underwent aseptic revision TKA surgery between 2017 and 2022. Patients were revised either for stiffness (Group 1) or aseptic loosening/instability (Group 2). The Insall-Salvati ratio (ISR) and Blackburne-Peel ratio (BPR) were used to evaluate the patellar position. ISR < 0.8 defined PB, while cases with ISR ≥ 0.8 and BPI < 0.54 were defined as PPB. ROM was measured and a subanalysis was conducted to investigate the progression of the values of ISR and BPR.
Results
55 patients comprised Group 1, and 59 patients comprised Group 2. Overall, 13 cases (11.4%) had PB before rTKA and 24 (21%) had PB after rTKA. Cases with PPB were 13 (11.4%) before and 34 (29.9%) after rTKA. Group 1 patients presented with more PB before and after rTKA (12.8% vs 10.2% and 27.3% vs 15.2% respectively). However, after rTKA Group 1 patients presented with less PPB (20%) compared to Group 2 (39%) (p = 0.02). In Group 1, patients with PPB after rTKA had less ROM compared to those without PPB [83.2 (± 21.9) vs 102.1 (± 19.9) (p = 0.025)]. The subanalysis (69 patients) showed a statistically significant decrease in ISR before and after rTKA (p = 0.041), and from the native knee to post-rTKA (p = 0.001). There was a statistically significant decrease in BPR before and after rTKA (p = 0.001) and from the native knee to both pre- and post-rTKA (p < 001).
Conclusion
After undergoing rTKA, the incidences of both patella baja (PB) and pseudo-patella baja (PPB) increased. Stiffness in the knee was associated with a higher incidence of PB, while non-stiffness cases showed a significantly higher incidence of PPB. Patients with stiff knees and PPB after rTKA experienced a significant reduction in range of motion (ROM). Additionally, the study revealed a noteworthy decrease in ISR and BPR with each subsequent surgery. This information is crucial for healthcare providers, as it sheds light on potential risks and outcomes of rTKA, allowing for improved patient management and surgical decision-making.
Level of evidence
III.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38488903</pmid><doi>10.1007/s00402-024-05234-4</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-9997-4846</orcidid></addata></record> |
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| subjects | Arthroplasty, Replacement, Knee - adverse effects Humans Incidence Joint Diseases - surgery Joint replacement surgery Knee Knee Joint - surgery Knee Prosthesis - adverse effects Knee Revision Surgery Medicine Medicine & Public Health Orthopedics Patella - surgery Range of Motion, Articular Retrospective Studies |
| title | Incidence of patella baja and pseudopatella baja in aseptic revision total knee arthroplasty |
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