Effectiveness of proximal tibial tubercle transfer in patients with patella baja after total knee arthroplasty
Abstract Purpose Patella baja after total knee arthroplasty (TKA) is a common problem that is usually treated via proximal transfer of the tibial tubercle. As the long‐term outcomes of this procedure are unclarified, this study aimed to investigate the changes in clinical function and radiographic p...
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Wiley
2022-01-01
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| Series: | Journal of Experimental Orthopaedics |
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| Online Access: | https://doi.org/10.1186/s40634-022-00452-4 |
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| author | Ines Unterfrauner Ruben Loretz Nathalie Kühne Florian Grubhofer Sandro F. Fucentese |
| author_facet | Ines Unterfrauner Ruben Loretz Nathalie Kühne Florian Grubhofer Sandro F. Fucentese |
| author_sort | Ines Unterfrauner |
| collection | DOAJ |
| description | Abstract Purpose Patella baja after total knee arthroplasty (TKA) is a common problem that is usually treated via proximal transfer of the tibial tubercle. As the long‐term outcomes of this procedure are unclarified, this study aimed to investigate the changes in clinical function and radiographic patellar height during five years of follow‐up. Methods Sixty patients with patella baja after TKA who underwent proximalisation of the tibial tubercle were followed up for a mean of 71 months (range 21–153 months). The pre‐ and postoperative range of motion (ROM) and clinical scores (Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) were compared. The radiographic patellar height was measured with the Caton‐Deschamps index (CDI), Blackburne‐Peel ratio (BP), and modified Insall‐Salvati index (MIS). Results Proximalisation of the tibial tubercle resulted in a significant improvement in the ROM from 80° to 88°. The KSS and WOMAC did not improve or even worsened after the intervention. The radiographic patellar height immediately after tibial tubercle transfer was not better than prior to the intervention (CDI 0.72 vs. 0.63, p = 0.72; BP 0.66 vs. 0.61, p = 0.72; MIS 1.59 vs. 1.55, p = 1.00) and further decreased significantly so that the mean final values were worse than the values in the native joint (CDI 0.59 vs. 0.78, p = 0.001; BP 0.58 vs. 0.74, p = 0.001; MIS 1.39 vs. 1.81, p < 0.001). Conclusion Proximalisation of the tibial tubercle in patients with patella baja after TKA does neither lead to significant improvements in the clinical outcome nor in the radiographic patellar height during long‐term follow‐up. Level of evidence III |
| format | Article |
| id | doaj-art-262bbd4ea0c449afb21d9bb70244f293 |
| institution | OA Journals |
| issn | 2197-1153 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj-art-262bbd4ea0c449afb21d9bb70244f2932025-08-20T02:05:21ZengWileyJournal of Experimental Orthopaedics2197-11532022-01-0191n/an/a10.1186/s40634-022-00452-4Effectiveness of proximal tibial tubercle transfer in patients with patella baja after total knee arthroplastyInes Unterfrauner0Ruben Loretz1Nathalie Kühne2Florian Grubhofer3Sandro F. Fucentese4Department of OrthopedicsBalgrist University HospitalUniversity of ZurichForchstrasse 3408008ZurichSwitzerlandDepartment of OrthopedicsBalgrist University HospitalUniversity of ZurichForchstrasse 3408008ZurichSwitzerlandUnit of Clinical and Applied ResearchBalgrist University HospitalUniversity of ZurichForchstrasse 3408008ZurichSwitzerlandDepartment of OrthopedicsBalgrist University HospitalUniversity of ZurichForchstrasse 3408008ZurichSwitzerlandDepartment of OrthopedicsBalgrist University HospitalUniversity of ZurichForchstrasse 3408008ZurichSwitzerlandAbstract Purpose Patella baja after total knee arthroplasty (TKA) is a common problem that is usually treated via proximal transfer of the tibial tubercle. As the long‐term outcomes of this procedure are unclarified, this study aimed to investigate the changes in clinical function and radiographic patellar height during five years of follow‐up. Methods Sixty patients with patella baja after TKA who underwent proximalisation of the tibial tubercle were followed up for a mean of 71 months (range 21–153 months). The pre‐ and postoperative range of motion (ROM) and clinical scores (Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) were compared. The radiographic patellar height was measured with the Caton‐Deschamps index (CDI), Blackburne‐Peel ratio (BP), and modified Insall‐Salvati index (MIS). Results Proximalisation of the tibial tubercle resulted in a significant improvement in the ROM from 80° to 88°. The KSS and WOMAC did not improve or even worsened after the intervention. The radiographic patellar height immediately after tibial tubercle transfer was not better than prior to the intervention (CDI 0.72 vs. 0.63, p = 0.72; BP 0.66 vs. 0.61, p = 0.72; MIS 1.59 vs. 1.55, p = 1.00) and further decreased significantly so that the mean final values were worse than the values in the native joint (CDI 0.59 vs. 0.78, p = 0.001; BP 0.58 vs. 0.74, p = 0.001; MIS 1.39 vs. 1.81, p < 0.001). Conclusion Proximalisation of the tibial tubercle in patients with patella baja after TKA does neither lead to significant improvements in the clinical outcome nor in the radiographic patellar height during long‐term follow‐up. Level of evidence IIIhttps://doi.org/10.1186/s40634-022-00452-4Proximal tibial tubercle transferTibial tubercle proximalisationTuberositas osteotomyPatella bajaPatellar heightTotal knee arthroplasty |
| spellingShingle | Ines Unterfrauner Ruben Loretz Nathalie Kühne Florian Grubhofer Sandro F. Fucentese Effectiveness of proximal tibial tubercle transfer in patients with patella baja after total knee arthroplasty Journal of Experimental Orthopaedics Proximal tibial tubercle transfer Tibial tubercle proximalisation Tuberositas osteotomy Patella baja Patellar height Total knee arthroplasty |
| title | Effectiveness of proximal tibial tubercle transfer in patients with patella baja after total knee arthroplasty |
| title_full | Effectiveness of proximal tibial tubercle transfer in patients with patella baja after total knee arthroplasty |
| title_fullStr | Effectiveness of proximal tibial tubercle transfer in patients with patella baja after total knee arthroplasty |
| title_full_unstemmed | Effectiveness of proximal tibial tubercle transfer in patients with patella baja after total knee arthroplasty |
| title_short | Effectiveness of proximal tibial tubercle transfer in patients with patella baja after total knee arthroplasty |
| title_sort | effectiveness of proximal tibial tubercle transfer in patients with patella baja after total knee arthroplasty |
| topic | Proximal tibial tubercle transfer Tibial tubercle proximalisation Tuberositas osteotomy Patella baja Patellar height Total knee arthroplasty |
| url | https://doi.org/10.1186/s40634-022-00452-4 |
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