FUNCTIONAL OUTCOME OF TOTAL KNEE REPLACEMENT WITH AND WITHOUT PATELLAR RESURFACING
Main Article Content
Keywords
PS, TKR, functional outcomes, knee osteoarthritis, kellgren-lawrence grade, postoperative outcomes
Abstract
Introduction: Total knee replacement (TKR) is a commonly performed surgery that greatly improves the management of end-stage knee osteoarthritis and related conditions. While TKR is generally effective at reducing pain and improving knee function, there is ongoing debate in the orthopedic community about whether to include patellar resurfacing (PS) in the procedure. PS involves replacing the kneecap and is thought to relieve anterior knee pain (AKP), enhance patellar tracking, and improve functional outcomes. However, concerns persist about possible complications like component loosening and fractures associated with PS.
Aims: To investigate the influence of patellar resurfacing on postoperative functional outcomes in patients undergoing TKR.
Methods: The study conducted a prospective observational analysis, comparing functional outcomes in 80 patients, divided into two groups: those who had TKR with PS (n=40) and those who had TKR without it (n=40). All patients were over 18 years old and had Kellgren-Lawrence grade 4 knee osteoarthritis, undergoing primary TKR. Data was collected preoperatively and at several postoperative time points (6 months, 1 year, and 2 years) to assess changes in functional outcomes.
Results: Both the PS and non-resurfacing groups demonstrated substantial progresses in clinical scores after TKR. At the 6-month postoperative mark, the PS group showed a remarkable mean improvement of 47.7 points on the knee pain scale, 46.2 points on the Knee Society Score (KSS), and 25.0 points on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Similarly, the non-resurfacing group exhibited significant improvements with a mean improvement of 48.7 points on the knee pain scale, 50.0 points on the KSS, and 25.0 points on the WOMAC. However, there were no statistically significant differences between the two groups at any of the postoperative time points (p > 0.05), indicating that PS did not provide a significant advantage in terms of pain relief or functional outcomes.
Conclusion: PS does not significantly improve functional outcomes or pain relief in TKR patients and does not increase the risk of complications. These findings provide crucial guidance for both orthopedic surgeons and patients in making informed decisions about TKR surgery.
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Muhammad Imran Haider
Assistant Professor Orthopedics, Nishtar Medical University, Multan - Pakistan
Adnan Nazir
Senior Registrar Orthopaedic Unit, Bahawal Victoria Hospital, Bahawalpur - Pakistan
Muhammad Imran Anjum
Senior Registrar Orthopaedic Surgery Victoria Hospital, Bahawalpur - Pakistan
Ahmad Jamal
Senior Registrar Orthopaedics, Nishtar Hospital, Multan - Pakistan
Muhammad Adeel Razzaque
Assistant Professor Orthopaedic, Bakhtawer Amin Hospital, Multan - Pakistan
Zahid Iqbal
FCPS Ortho, Medical Officer, Orthopedic Unit, Bahawalpur Victoria Hospital, Bahawalpur - Pakistan