J Knee Surg 2017; 30(02): 185-192
DOI: 10.1055/s-0036-1584186
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Clinical and Radiologic Outcomes of Partial Lateral Patellar Facetectomy in Total Knee Arthroplasty

Chang-Wan Kim
1   Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Busan, Republic of Korea
,
Chang-Rack Lee
1   Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Busan, Republic of Korea
,
Seung-Suk Seo
2   Department of Orthopedic Surgery, Bumin Hospital, Busan, Republic of Korea
,
Heui-Chul Gwak
1   Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Busan, Republic of Korea
,
Jung-Han Kim
1   Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Busan, Republic of Korea
,
Joon-Ho Park
1   Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Busan, Republic of Korea
› Author Affiliations
Further Information

Publication History

12 January 2016

28 March 2016

Publication Date:
20 May 2016 (online)

Abstract

Recently, some authors have performed partial lateral patellar facetectomy in total knee arthroplasty (TKA) and reported good results. However, research on partial lateral patellar facetectomy in TKA is still lacking. The aim of this study was to evaluate the clinical and radiologic results of partial lateral patellar facetectomies in patellar non-resurfacing and resurfacing TKAs. Total 251 TKAs (patellar non-resurfacing: 131; resurfacing: 120) that were followed up for at least 24 months to evaluate the clinical and radiologic results of partial lateral patellar facetectomies in patellar non-resurfacing and resurfacing TKAs were retrospectively reviewed. The radiologic evaluations involved assessments of the patellar tilt angle and the lateral patellar displacement, and the clinical evaluations involved assessments of the Knee Society knee score, Knee Society function score, Feller patellar score, and Kujala score. In patellar non-resurfacing TKA, the average postoperative patellar tilt angle and lateral patellar displacement of the group that did not undergo facetectomy were 7.0 ± 4.8 degrees and 2.4 ± 3.6 mm, respectively, and the average postoperative patellar tilt angle and lateral patellar displacement of the group that did undergo facetectomy were 4.0 ± 3.8 degrees and 0.7 ± 2.5 mm, respectively. Significant differences were observed in the postoperative patellar tilt angle and lateral patellar displacement (p < 0.001 and p = 0.004, respectively). In patellar resurfacing TKA, while the patellar tilt angle showed a significant difference between the group that underwent facetectomy (6.7 ± 3.1 degrees) and the group that did not (8.3 ± 4.4 degrees) (p = 0.023), it exhibited no difference in the lateral patellar displacement between the two groups. In both patellar non-resurfacing TKA and resurfacing TKA, the postoperative clinical results did not show any difference between no-facetectomy group and facetectomy group. Partial lateral patellar facetectomies in patellar non-resurfacing and resurfacing TKAs improved the patellar tilt angles and patellar lateral displacements but were not related to improvements in the clinical outcomes in the minimum 2-year follow-up.

 
  • References

  • 1 Garcia RM, Kraay MJ, Goldberg VM. Isolated resurfacing of the previously unresurfaced patella total knee arthroplasty. J Arthroplasty 2010; 25 (5) 754-758
  • 2 Mayman D, Bourne RB, Rorabeck CH, Vaz M, Kramer J. Resurfacing versus not resurfacing the patella in total knee arthroplasty: 8- to 10-year results. J Arthroplasty 2003; 18 (5) 541-545
  • 3 Meftah M, Ranawat AS, Ranawat CS. The natural history of anterior knee pain in 2 posterior-stabilized, modular total knee arthroplasty designs. J Arthroplasty 2011; 26 (8) 1145-1148
  • 4 Parvizi J, Mortazavi SM, Devulapalli C, Hozack WJ, Sharkey PF, Rothman RH. Secondary resurfacing of the patella after primary total knee arthroplasty does the anterior knee pain resolve?. J Arthroplasty 2012; 27 (1) 21-26
  • 5 Burnett RS, Bourne RB. Indications for patellar resurfacing in total knee arthroplasty. Instr Course Lect 2004; 53: 167-186
  • 6 Karnezis IA, Vossinakis IC, Rex C, Fragkiadakis EG, Newman JH. Secondary patellar resurfacing in total knee arthroplasty: results of multivariate analysis in two case-matched groups. J Arthroplasty 2003; 18 (8) 993-998
  • 7 O'Donoghue DH. Facetectomy. South Med J 1972; 65 (6) 645-654
  • 8 Paulos LE, O'Connor DL, Karistinos A. Partial lateral patellar facetectomy for treatment of arthritis due to lateral patellar compression syndrome. Arthroscopy 2008; 24 (5) 547-553
  • 9 Wetzels T, Bellemans J. Patellofemoral osteoarthritis treated by partial lateral facetectomy: results at long-term follow up. Knee 2012; 19 (4) 411-415
  • 10 Lakstein D, Naser M, Adar E, Atoun E, Edelman A, Hendel D. Partial lateral patellar facetectomy as an alternative to lateral release in total knee arthroplasty (TKA). J Arthroplasty 2014; 29 (11) 2146-2149
  • 11 Pagenstert G, Seelhoff J, Henninger HB, Wirtz DC, Valderrabano V, Barg A. Lateral patellar facetectomy and medial reefing in patients with lateral facet syndrome after patellar-retaining total knee arthroplasty. J Arthroplasty 2014; 29 (11) 2156-2162
  • 12 Zhang LZ, Zhang XL, Jiang Y, Wang Q, Chen YS, Shen H. Lateral patellar facetectomy had improved clinical results in patients with patellar-retaining total knee arthroplasty. J Arthroplasty 2012; 27 (8) 1442-1447
  • 13 Nikolaus OB, Larson DR, Hanssen AD, Trousdale RT, Sierra RJ. Lateral patellar facet impingement after primary total knee arthroplasty: it does exist. J Arthroplasty 2014; 29 (5) 970-976
  • 14 Fukui N, Nakagawa T, Murakami S, Hiraoka H, Nakamura K. A modified system of stress radiography for patellofemoral instability. J Bone Joint Surg Br 2003; 85 (8) 1128-1133
  • 15 Merchant AC, Mercer RL, Jacobsen RH, Cool CR. Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg Am 1974; 56 (7) 1391-1396
  • 16 Chia SL, Merican AM, Devadasan B, Strachan RK, Amis AA. Radiographic features predictive of patellar maltracking during total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2009; 17 (10) 1217-1224
  • 17 Grelsamer RP, Bazos AN, Proctor CS. Radiographic analysis of patellar tilt. J Bone Joint Surg Br 1993; 75 (5) 822-824
  • 18 Kong CG, Cho HM, Suhl KH, Kim MU, In Y. Patellar tracking after total knee arthroplasty performed without lateral release. Knee 2012; 19 (5) 692-695
  • 19 Fukagawa S, Matsuda S, Mizu-uchi H, Miura H, Okazaki K, Iwamoto Y. Changes in patellar alignment after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2011; 19 (1) 99-104
  • 20 Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 1989; (248) 13-14
  • 21 Feller JA, Bartlett RJ, Lang DM. Patellar resurfacing versus retention in total knee arthroplasty. J Bone Joint Surg Br 1996; 78 (2) 226-228
  • 22 Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy 1993; 9 (2) 159-163