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Research Paper | Orthopaedic Surgery | India | Volume 14 Issue 2, February 2025 | Rating: 6.1 / 10
Patellofemoral Joint Overstuffing and its Effect on Clinical Outcome in Total Knee Arthroplasty without Patella Resurfacing
Dr. Bighnesh Dash
Abstract: Objective: To analyze the influencing factors for patellofemoral joint (PFJ) overstuffing following total knee arthroplasty (TKA) without patella resurfacing, and explore the effect of PFJ overstuffing on clinical efficacy. Methods: Retrospective analysis was conducted on 84 patients with end-stage knee osteoarthritis who underwent TKA without patella resurfacing at our hospital between March 2023 and October 2024. In this study, PFJ overstuffing was defined as a postoperative PFJ distance greater than 1 mm compared to the preoperative measurement and the occurrence of PFJ was counted. The patients were divided into the overstuffing group (n=55) and the non-overstuffing group (n=29) to count the patellar thickness and thickness of femoral anterior condyle in all patients before and after surgery, and analyze the influencing factors for postoperative PFJ overstuffing in such patients. Patients were followed up for 1 year to compare the recovery time of postoperative pain, score of visual analogue scale (VAS) and flexion activity. Results: There was no significant difference in patellar thickness between preoperative and postoperative measurements of the patients (P>0.05). However, the thickness of the femoral anterior condyle and the PFJ distance after surgery increased significantly compared with those before surgery (P<0.05). Among the 84 patients, 55 cases (64.88%) experienced PFJ overstuffing. The risk of PFJ overstuffing was higher in female patients than in male (P<0.05). The preoperative thickness of the femoral anterior condyle in the overstuffing group was significantly smaller compared to the non-overstuffing group (P<0.001). Compared with the non-overstuffing group, the overstuffing group had longer recovery time of postoperative pain (P<0.05), and had lower flexion activity at 1 year after surgery (P<0.001). However, no significant difference was found in VAS score between the overstuffing group and the non-overstuffing group at 1 year after surgery (P>0.05). Spearman rank correlation analysis indicated females tend to have a lower preoperative thickness of the femoral anterior condyle (r=-0.424, P<0.001), as well as a positive postoperative PFJ overstuffing (r=0.237, P<0.05). Furthermore, there was a negative correlation between preoperative thickness of the femoral anterior condyle and postoperative PFJ overstuffing (r=-0.540, P<0.001). Conclusion: Following TKA without patella resurfacing, there is a high risk of PFJ overstuffing, particularly among female patients and those with a small thickness of the femoral anterior condyle. Therefore, special attention should be given to these high-risk groups during clinical treatment.
Keywords: Without patella resurfacing, Total knee arthroplasty, Patellofemoral joint, Overstuffing phenomenon, Influencing factors
Edition: Volume 14 Issue 2, February 2025,
Pages: 224 - 229