Impact of osteoarthritis aetiology and implant constraint on the risk of secondary patellar resurfacing after total knee arthroplasty: An analysis of German Arthroplasty Registry (EPRD) data.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 42006229.
- Also identified by DOI 10.1002/jeo2.70720 and PMC identifier 13084700.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
The benefit of patella resurfacing (PR) in primary total knee arthroplasty (TKA) remains debated. While outcomes appear similar, unsurfaced patellae show higher revision rates. Existing studies are limited by heterogeneous cohorts. This study assessed the risk of secondary PR in relation to the level of constraint and primary procedure complexity (idiopathic vs. posttraumatic osteoarthritis). Using registry data, 258,669 primary TKAs without primary PR were analysed. Demographics, implant constraint and subsequent revisions were recorded. The primary endpoint was secondary PR (without additional femoral or tibial implant removal) over a follow-up period of up to 8 years. Cruciate-retaining (CR) designs showed the lowest revision risk (ca. 1%), whereas posterior-stabilised (PS) designs showed the highest (ca. 2.0-2.5%, hazard ratio = 1.8 [95% confidence interval = 1.66-1.99], <i>p</i> < 0.001). The majority of secondary PR occurred within 4 years. No differences were found between idiopathic and posttraumatic groups. Registry data indicate higher revision risk with PS versus CR designs, regardless of index surgery complexity. Level III.