Retention of the infrapatellar fat pad does not influence the outcome of total knee arthroplasty: a systematic review.

IF 5.2 2区医学 Q1 Medicine

British medical bulletin Pub Date : 2025-09-01 DOI:10.1093/bmb/ldaf010

Luise Schäfer, Nicola Maffulli, Michael Kurt Memminger, Martina Feierabend, Ulf Krister Hofmann, Filippo Migliorini

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引用次数: 0

Abstract

Introduction: To improve patient satisfaction after total knee arthroplasty (TKA), retention of the infrapatellar fat pad (IPFP) is advocated.

Source of data: Recently published literature identified from PubMed, EMBASE, Scopus, and Google Scholar.

Areas of agreement: TKA is routinely performed in patients with end-stage joint osteoarthritis, but 18% to 11% of patients are unsatisfied after surgery.

Areas of controversy: Clinical investigations that compared IPFP resection versus retention are limited.

Growing points: Following the 2020 PRISMA statement, the present systematic review compared resection versus retention of the IPFP in TKA in range of motion (ROM), patellar height, patient-reported outcome measures (PROMs), and complications.

Areas timely for developing research: At a mean duration of 18.4 ± 6.6 months of follow-up, no difference was found in ROM, patellar height, PROMs, and the rate of pain in the anterior aspect of the knee. The outcomes of TKA are not influenced by IPFP retention or excision. Based on the available scientific literature, surgeons could retain the IPFP if suitable visibility and exposure are possible, but resect it if necessary to facilitate exposure during TKA. Further high-level randomized controlled trials with sustained follow-up periods are required to prove the superiority of one surgical technique over the other.

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髌下脂肪垫的保留不影响全膝关节置换术的结果：一项系统综述。

简介：为了提高全膝关节置换术（TKA）后患者的满意度，建议保留髌下脂肪垫（IPFP）。数据来源：从PubMed， EMBASE， Scopus和谷歌Scholar中确定的最近发表的文献。共识领域：TKA是终末期骨性关节炎患者的常规手术，但18% - 11%的患者术后不满意。争议领域：比较IPFP切除与保留的临床研究是有限的。要点：继2020年PRISMA声明之后，本系统综述比较了TKA中IPFP切除与保留的运动范围（ROM）、髌骨高度、患者报告的结果测量（PROMs）和并发症。及时开展研究的领域：在平均18.4±6.6个月的随访期间，在ROM，髌骨高度，PROMs和膝关节前部疼痛率方面没有发现差异。TKA的结果不受IPFP保留或切除的影响。根据现有的科学文献，外科医生可以保留IPFP，如果合适的能见度和暴露是可能的，但如果有必要切除IPFP，以促进TKA期间的暴露。需要进一步的高水平随机对照试验来证明一种手术技术优于另一种手术技术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British medical bulletin 医学-医学：内科

CiteScore

13.10

自引率

1.50%

发文量

审稿时长

>12 weeks

期刊介绍： British Medical Bulletin is a multidisciplinary publication, which comprises high quality reviews aimed at generalist physicians, junior doctors, and medical students in both developed and developing countries. Its key aims are to provide interpretations of growing points in medicine by trusted experts in the field, and to assist practitioners in incorporating not just evidence but new conceptual ways of thinking into their practice.