Improved postoperative kneeling ability in posterior stabilized total knee arthroplasty with medialized dome-patella resurfacing: A retrospective comparative outcome analysis

Sonja Häckel; Lorenz Haldemann; Michael Finsterwald; Piers Yates

doi:10.1016/j.jisako.2023.12.008

Improved postoperative kneeling ability in posterior stabilized total knee arthroplasty with medialized dome-patella resurfacing: A retrospective comparative outcome analysis

J ISAKOS. 2024 Apr;9(2):153-159. doi: 10.1016/j.jisako.2023.12.008. Epub 2023 Dec 28.

Authors

Sonja Häckel¹, Lorenz Haldemann², Michael Finsterwald³, Piers Yates⁴

Affiliations

¹ Department of Orthopaedics, Fiona Stanley Fremantle Hospitals Group, Murdoch, Western Australia, 6150, Australia; Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; Orthopaedic Research Foundation of Western Australia (ORFWA), Perth, Western Australia 6010, Australia. Electronic address: sonja.haeckel@insel.ch.
² Department of Orthopaedics, Fiona Stanley Fremantle Hospitals Group, Murdoch, Western Australia, 6150, Australia; Department of Orthopaedic Surgery and Traumatology, Interlaken Hospital, 3800 Unterseen, Switzerland; Fremantle University Hospitals, Fremantle, Western Australia, 6160, Australia; Orthopaedic Research Foundation of Western Australia (ORFWA), Perth, Western Australia 6010, Australia.
³ Department of Orthopaedics, Fiona Stanley Fremantle Hospitals Group, Murdoch, Western Australia, 6150, Australia; Orthopaedic Research Foundation of Western Australia (ORFWA), Perth, Western Australia 6010, Australia.
⁴ Department of Orthopaedics, Fiona Stanley Fremantle Hospitals Group, Murdoch, Western Australia, 6150, Australia; Fremantle University Hospitals, Fremantle, Western Australia, 6160, Australia; St John of God Murdoch Private Hospital, Murdoch, Western Australia, 6150, Australia; Orthopaedic Research Foundation of Western Australia (ORFWA), Perth, Western Australia 6010, Australia.

PMID: 38159866
DOI: 10.1016/j.jisako.2023.12.008

Abstract

Objectives: This investigation aimed to evaluate if the modifications to prosthesis designs improve patients' clinical and functional outcomes after total knee arthroplasty (TKA), with a special focus on pain and kneeling ability.

Methods: Retrospective and comparative analysis of consecutive patients who were treated with posterior stabilized TKA using two different prostheses designs (single surgeon, single vendor). Group 1 received a traditional design TKA (PFC Sigma; DePuy, Inc., Warsaw, IN) with conventional dome-patella resurfacing, and group 2 received a modern design implant (Attune; DePuy, Inc., Warsaw, IN) with medialized dome-patella resurfacing. Functional outcome (range of motion: ROM) and the Oxford Knee Score (OKS) were collected preoperatively, at 4-6 weeks and 12 months following surgery.

Results: Ninety-nine participants were included. Of these, 30 received traditional-design implants and 69 received modern-design knee implants. The comparison between the two implants showed a statistically significant increase in total OKS and kneeling ability in the modern design cohort at 1-year follow-up compared to the traditional design cohort (p < 0.01). In the modern design group, 53% (N = 37) could kneel easily or with little difficulty, compared to 30% (N = 9) in the traditional design group. No statistically significant differences in ROM or the OKS pain component were seen.

Conclusion: The incorporation of a medialized dome-patella in modern knee implant design may offer advantages over traditional designs, as seen in improved total OKS and kneeling ability at one-year follow-up. Further research with larger cohorts is needed to confirm these findings and explore the broader impact of implant design changes on patient outcomes.

Level of evidence: Clinical Study, Level III.

Keywords: Attune knee implant; Kneeling; Medialized dome-patella resurfacing; PFC sigma knee implant; Posterior stabilized TKA; Total knee arthroplasty.

MeSH terms

Arthroplasty, Replacement, Knee*
Humans
Knee Joint / surgery
Pain
Patella / surgery
Retrospective Studies