Journal of Knee Surgery最新文献

{"title":"Robotically Assisted Medial Reduction Osteotomy: A Technique Based on the Pythagorean Theorem.","authors":"Olivia J Bono, Christopher Wester, James V Bono","doi":"10.1055/a-2664-7508","DOIUrl":"10.1055/a-2664-7508","url":null,"abstract":"<p><p>Varus deformity can present a significant challenge for limb alignment correction and balancing in total knee arthroplasty (TKA). One technique to address these challenges is a medial reduction osteotomy. This article describes utilization of a robotic platform to perform a safe and accurate medial subtraction osteotomy prior to balancing and bony resections. Deformity correction can be predicted by the Pythagorean Theorem. Computed tomography-based robotic systems can be used to perform medial reduction osteotomy of the tibia in the setting of significant varus deformity in patients undergoing TKA. Prior to balancing and bony cuts, the tibial component is downsized \"virtually\" from the planned size. Through lateralization of the component, the excess medial bone can be mapped via tracking of the registration probe and removed. The amount of medial tibial bone resected determines the amount of laxity that will be created when the tibia is reduced under the femur when implants are placed. Following this, soft tissue tensioning, planning, bony resections, and trialing can progress as normal for a robotic total knee. Through the described technique, the authors have been able to predict the amount of coronal plane correction based on the size of the osteotomized fragment using the Pythagorean Theorem. Robotic guidance of a medial subtraction osteotomy provides a safe and predictable means of varus correction. This is beneficial in that it can be performed with great accuracy and prior to any further balancing maneuvers or bony cuts.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Cultural Adaptation, Validity, and Reliability of the Arabic Version of the Western Ontario Meniscal Evaluation Tool.","authors":"Waleed Albishi, Nasser M AbuDujain, Ibraheem Alyami, Zyad A Aldosari, Omar A Aldosari, Mohammed N Alhuqbani","doi":"10.1055/a-2664-7377","DOIUrl":"https://doi.org/10.1055/a-2664-7377","url":null,"abstract":"<p><p>The Western Ontario Meniscal Evaluation Tool (WOMET) is a survey developed specifically to assess the health-related quality of life (HRQoL) of patients with meniscal pathology. This study aims to culturally adapt and validate the WOMET in Arabic. The Arabic version of the WOMET was modified according to cross-cultural adaptation best practices. The study included 47 patients with meniscal pathology. The construct validity of the study was assessed using the Lysholm and 36-Item Short Form (SF-36). Overall, 22 participants took the Arabic WOMET test twice to evaluate the test-retest reliability. The Arabic WOMET demonstrated a Cronbach's α value of 0.894 and an intraclass correlation coefficient of 0.906, indicating high reliability. The subscales were affected by the ceiling and floor effects by 0.0 to 2.1% and 0 to 4.3%, respectively. Furthermore, the Arabic WOMET exhibited correlation coefficients of 0.39 and 0.57 with respect to the Lysholm and SF-36 physical functions, respectively. The Arabic version of WOMET is a reliable instrument for assessing the HRQoL of Arabic-speaking patients with meniscal disease.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Nerve Blocks for Primary Total Knee Arthroplasty in Chronic Opioid Patients.","authors":"Cameron K Ledford, Nicolas E Giusti, Daniel S Ubl, Mason R Kapple, Steven R Clendenen, Benjamin K Wilke","doi":"10.1055/a-2672-2907","DOIUrl":"10.1055/a-2672-2907","url":null,"abstract":"<p><p>Postoperative pain control after total knee arthroplasty (TKA) remains challenging, particularly in patients utilizing chronic opioids preoperatively. Our study aimed to evaluate the effect of regional nerve blockade on perioperative pain control outcomes after TKA in patients using or not using chronic preoperative opioids. A retrospective review of our institutional database identified 434 chronic opioid patients defined as documented ongoing use greater than 3 months prior to contemporary TKA. Patients were 1:1 matched to nonopioid users based upon age, sex, body mass index, and regional block type (single-shot adductor canal block [ACB, 29%], 3-day ACB catheter [31%], or no block [41%]). All patients underwent primary TKA using periarticular injections and contemporary multimodal pain management. Immediate and 90-day postoperative outcomes, including Knee Osteoarthritis Outcome Score, Junior (KOOS, Jr), were compared via univariate analysis among the matched cohort and regional block type among chronic opioid patients. Chronic opioid patients demonstrated higher inpatient opioid use than controls (90 vs. 65 oral morphine equivalents [OMEs], respectively, <i>p</i> < 0.01), but no significant differences existed in length of stay (LOS), discharge pain scores, 90-day readmission or KOOS, Jr (all <i>p</i> ≥ 0.05). When comparing chronic opioid patients according to block type, those receiving no block had the highest LOS (1.6 days, <i>p</i> < 0.01), discharge pain score (5.0, <i>p</i> < 0.01), and inpatient opioid use (80 OMEs, <i>p</i> < 0.01) compared with either ACB. The subgroup receiving an ACB catheter demonstrated a significantly higher 90-day readmission rate (9%, <i>p</i> < 0.05). Patients utilizing chronic opioids preoperatively require more opioids in the immediate postoperative period after TKA compared with nonopioid users despite contemporary modalities. Nonetheless, the use of any type of ACB provides improved pain control in these patients.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Primary Femoral Bone Tunnel Position on Postoperative Outcomes and Femoral Bone Tunnel Creation in Revision ACL Reconstruction.","authors":"Kazumi Goto, Eisaburo Honda, Shin Sameshima, Miyu Inagawa, Koji Matsuo, Junki Shiota, Hitoshi Takagi, Takaki Sanada","doi":"10.1055/a-2664-7701","DOIUrl":"10.1055/a-2664-7701","url":null,"abstract":"<p><p>The impact of primary femoral tunnel position on rerupture rates following revision anterior cruciate ligament reconstruction (ACLR) remains unclear. This study aimed to explore whether the anatomical placement of the primary femoral tunnel affects rerupture risk, tunnel positioning at revision surgery, and postoperative clinical outcomes. Among 165 patients who underwent revision ACLR at our institution between 2018 and 2022, 78 cases with a minimum of 2 years of follow-up were included. The primary femoral tunnel position was evaluated using Bernard and Hertel's quadrant method on 3D CT scans. Patients were categorized into group A (anatomical position) and group N (nonanatomical position). Rerupture rate, tunnel position at revision ACLR, and clinical outcomes were compared between the groups. Subgroup analyses were conducted based on primary surgical technique (single-bundle [SB] vs. double-bundle [DB]). Additionally, multivariate logistic regression analysis was performed to identify independent predictors of rerupture. Rerupture occurred in three of 39 cases (7.7%) in group A and six of 39 cases (15.4%) in group N (<i>p</i> = 0.48). There were no significant differences in age, sex, height, weight, sports type, or posterior tibial slope. Anatomical tunnel placement at revision was achieved in 94.9% of group A and 79.5% of group N (<i>p</i> = 0.087). No significant differences in Knee Injury and Osteoarthritis Outcome Score or ACL-return to sport after injury scale were observed at 2 years postoperatively. Subgroup analysis based on primary surgical technique (SB vs. DB) revealed no significant differences in rerupture rates or femoral tunnel positioning at revision. Multivariate logistic regression identified anatomical tunnel placement during the revision surgery as the only independent protective factor against rerupture (odds ratio: 0.145; 95% confidence interval: 0.022-0.951; <i>p</i> = 0.044). Anatomical tunnel placement during primary ACLR appears to be a key factor associated with a reduced risk of rerupture following revision ACLR. These exploratory findings underscore the importance of accurate tunnel positioning and should be interpreted cautiously due to the limited sample size. LEVEL OF EVIDENCE:  Level III.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newer versus Older Implant Systems from a Single Manufacturer and Cause-Specific Revision Risk following Primary Total Knee Arthroplasty.","authors":"Matthew P Kelly, Heather A Prentice, Brian H Fasig, Dhiren S Sheth, Nithin C Reddy, Monti Khatod, Elizabeth W Paxton","doi":"10.1055/a-2664-7627","DOIUrl":"10.1055/a-2664-7627","url":null,"abstract":"<p><p>Novel implant systems have design modifications that seek to improve total knee arthroplasty (TKA) survivorship. We evaluated overall and cause-specific revision risk for a newer generation implant system compared with its predecessor from the same manufacturer. We conducted a cohort study using data from the United States-based Kaiser Permanente Total Joint Replacement Registry. Adult patients who underwent primary, fully cemented, fixed-bearing TKA for osteoarthritis between 2009 and 2022 were identified. Only two implant systems from the manufacturer were included: the newer generation (<i>n</i> = 22,287) and the older generation (<i>n</i> = 37,105). Multivariable Cox regression was used to evaluate overall and cause-specific aseptic revision risk. In the adjusted analyses, no difference in risk was observed for the newer compared with older generation system in the first 4-year follow-up (hazard ratio [HR] = 0.94, 95% confidence interval [CI] = 0.74-1.19); however, a higher risk was observed after 4-year follow-up (HR = 2.09, 95% CI = 1.41-3.08). This higher risk was due to loosening (within 4 years: HR = 0.90, 95% CI = 0.59-1.37; after 4 years: HR = 2.88, 95% CI = 1.84-4.51); no differences were observed for other revision reasons. When considering constructs utilizing different trays of the newer generation system, the higher risk of revision for loosening was observed only when the first iteration of the tray was used (HR = 1.94, 95% CI = 1.37-2.77); no difference was observed for constructs utilizing the subsequent iterations of the tray, which underwent design changes, when compared with the older generation TKA system (HR = 0.45, 95% CI = 0.20-1.01). We found no survivorship advantage with a newer TKA design compared with a preceding design from the same manufacturer. The higher risk of revision for loosening in the newer generation constructs was limited to those utilizing the first tray iteration, which is now discontinued by the manufacturer. The higher revision risk was not observed with subsequent iterations of the newer generation construct relative to the older generation. LEVEL OF EVIDENCE:  Level III.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed Tomography-Based Analysis of Implant Positioning after Total Knee Arthroplasty: A Randomized Controlled Trial Comparing Conventional and Robotic Arm-Assisted Procedures.","authors":"Clément Horteur, Benoit Gaulin, Pierre Pascal, Corentin Leroy, Joris Giai, Jérôme Murgier, Johannes Barth, Régis Pailhé","doi":"10.1055/a-2664-7551","DOIUrl":"https://doi.org/10.1055/a-2664-7551","url":null,"abstract":"<p><p>The aim of this study was to evaluate the deviation from the surgical plan of femoral and tibial components positioning after robotic total knee arthroplasty (R-TKA) compared with conventional TKA (C-TKA) based on postoperative three-dimensional computed tomography (3D-CT). This prospective randomized trial included 60 patients: 29 in the C-TKA group and 31 in the R-TKA one. Early postoperative 3D-CT-based analysis of implants positioning was performed. Measurements were performed twice by two observers, showing good to excellent intra- and interobserver reproducibility (interclass coefficient ranging from 0.71 to 0.96). Absolute deviations from the surgical plan (mechanical alignment in the C-TKA group and personalized alignment in the R-TKA group) were compared between groups. Primary endpoint was coronal lower limb frontal alignment: hip-knee-ankle (HKA) angle. Secondary endpoints were frontal, sagittal, and rotational positioning of both tibial and femoral components. Planned frontal lower limb alignment was similarly achieved in both group: HKA angle mean difference was 2.28 ± 1.81 degrees in the C-TKA group and 1.84 ± 1.46 degrees in the R-TKA group (<i>p</i> = 0.379). Deviations from the surgical plan were lower in the R-TKA group compared with the C-TKA group for all parameters, except tibial rotation (9.02 ± 4.51 vs. 7.42 ± 3.96 degrees, respectively). These differences turned out to be statistically significant only for sagittal alignment of both femoral (1.71 ± 1.34 vs. 3.61 ± 2.05 degrees, <i>p</i> < 0.001) and tibial (3.78 ± 1.15 vs. 4.94 ± 1.99 degrees, <i>p</i> = 0.018) components. Accuracy in achieving planned coronal lower limb alignment is not higher using R-TKA compared with C-TKA. Regarding component positioning, R-TKA appears superior in the sagittal plane while no significant differences were identified in terms of frontal alignment and rotation. LEVEL OF EVIDENCE:  I.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors and Thresholds for Minimal Clinically Important Difference in Worsening after Unicompartmental Knee Arthroplasty.","authors":"Perry L Lim, Marcos R Gonzalez, Hany S Bedair, Christopher M Melnic","doi":"10.1055/a-2555-1941","DOIUrl":"10.1055/a-2555-1941","url":null,"abstract":"<p><p>The rising demand for unicompartmental knee arthroplasty (UKA) in the United States has led to high 1-year patient satisfaction rates. However, some patients experience substantial declines in patient-reported outcome measures (PROMs) postoperatively, which we refer to as \"minimal clinically important difference for worsening\" (MCID-W). We sought to define MCID-W values for specific PROMs and identify risk factors associated with PROMIS Physical Function Short Form 10a (PROMIS PF-10a) declines after UKA. We conducted a retrospective study of 760 patients undergoing UKA at our institution between 2016 and 2023. Preoperative and postoperative PROMIS PF-10a, PROMIS global physical, and knee injury and osteoarthritis outcome score-physical function short-form (KOOS-PS) scores were collected. Patients were stratified upon reaching minimal clinically importance difference for improvement (MCID-I), MCID-W, or \"no significant change\" (score between MCID-W and MCID-I). MCID-W and MCID-I values were determined using a distribution-based method. Logistic regression was performed to identify risk factors for scoring below MCID-W. We established the following MCID-I and MCID-W thresholds: PROMIS PF-10a (+3.00 and -1.64), KOOS-PS (+6.25 and -3.42), and PROMIS Global-Physical (+2.72 and -1.55). Bivariate analysis revealed differences in terms of revision (<i>p</i> = 0.02), reoperation (<i>p</i> = 0.03), postoperative complications (<i>p</i> = 0.002), deep venous thrombosis (DVT; <i>p</i> < 0.001), and pneumonia (<i>p</i> = 0.01) between cohorts. Body mass index >35 (odds ratio [OR] = 2.49), postoperative complications (OR = 5.09), pneumonia (OR = 22.39), DVT (OR = 9.27), and preoperative PROMIS PF-10a scores (OR = 1.07) were risk factors for scoring below the MCID-W threshold, whereas age > 80 (OR = 2.89) and preoperative PROMIS PF-10a scores (OR = 1.05) were risk factors for failing to achieve MCID-I. Our study established MCID-W values for pivotal PROMs after primary UKAs. We found that 8.8% of patients scored below MCID-W, highlighting the need to improve patient selection and perioperative care in UKA.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"525-532"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Improvement in Postoperative Clinical Outcomes without Patellar Resurfacing in Patella-Friendly Design of Medial Pivot TKA.","authors":"Leo Cooper, Brewer Owen, Tatsuya Soeno, Stephen Wahl, Jeffrey B Stambough, C Lowry Barnes, Simon C Mears, Benjamin M Stronach","doi":"10.1055/a-2421-5572","DOIUrl":"10.1055/a-2421-5572","url":null,"abstract":"<p><p>There is continued debate about the efficacy and indications for patellar resurfacing in total knee arthroplasty (TKA), especially with the emergence of patella-friendly designs. This study aimed to compare the postoperative outcomes in patients undergoing TKA with or without patellar resurfacing using the same implant design. This is a retrospective cohort study of patients who underwent TKA including those with patellar resurfacing (PR group) and those without (NPR group). Demographic data included age, gender, side of surgery, operative time, and body mass index (BMI). Outcomes included preoperative, 2-week, 6-week, and 1-year postoperative Knee Injury and Osteoarthritis Outcome Score and Joint Replacement (KOOS, JR) values along with knee range of motion (ROM). Postoperative complications were recorded. The power analysis with a large effect size indicated that a minimum sample size of 54 was required for Student's <i>t</i>-test and 34 for the paired <i>t</i>-test. A total of 90 medial pivot (MP) TKA were included in this study. There were 30 knees in the PR group and 60 in the NPR group. There was no significant difference between the groups for all demographic data, preoperative and postoperative ROM, and KOOS, JR values at all time points (<i>p</i> > 0.05 for all variables). The KOOS, JR significantly improved in the NPR groups at 2 weeks, 6 weeks, and 1 year postoperatively when compared with the preoperative score and at 6 weeks and 1 year postoperatively in the PR group (<i>p</i> < 0.01). No revisions related to the patellofemoral joint were observed in patients initially undergoing patellar resurfacing. One patient in the NPR group required secondary patellar resurfacing. The patella-friendly MP TKA yielded favorable postoperative outcomes, with or without patellar resurfacing. Improvements in KOOS, JR were observed earlier in the NPR group when compared with the PR group, suggesting that patellar resurfacing may not always be necessary for modern TKA designs. LEVEL OF EVIDENCE:  Retrospective cohort study, Level III.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"512-517"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patellar Overstuffing in Total Knee Arthroplasty Results in Decreased Extensor Mechanism Efficiency.","authors":"Brandon R Bukowski, Sonia K Chandi, Pravjit Bhatti, Paola Jimenez, Nathan Lenz, Fred D Cushner, Steven B Haas, Brian P Chalmers","doi":"10.1055/a-2514-9655","DOIUrl":"10.1055/a-2514-9655","url":null,"abstract":"<p><p>Patellofemoral offset is influenced by patellar thickness in total knee arthroplasty (TKA), with effects on extensor mechanism efficiency (EME), patellar contact moment arm (PCMA), and patellar contact force (PCF). This study utilized a computational model to better quantify these measures during knee range of motion (ROM). A computational model of a cruciate-sacrificing, posterior-stabilized TKA design was used to quantify moments at knee flexion angles from 0° to 135° when patella thickness was increased (\"overstuffed\") or decreased (\"understuffed\") by 2 mm and 5 mm from normal. Outcomes included changes in EME, PCMA, PCF, tibial tubercle moment arm (TTMA), and the quadriceps moment arm (QMA). Overstuffing of the patellofemoral articulation by 2 mm and 5 mm decreased EME up to 12 and 28%, respectively, with an 8% and 16% increase in EME with understuffing that peaked at 25° knee flexion. The QMA increased up to 5 and 12% with overstuffing by 2 mm and 5 mm and decreased up to 5% and 14% with understuffing, respectively. There was an increase in the PCMA/PCF, which opposed the QMA, up to 8%/17% and 16%/39% with overstuffing by 2 mm and 5 mm, respectively. The PCMA/PCF decreased up to 3%/12% and 8%/33% with understuffing by 2 mm and 5 mm, respectively. In this computational model, increased patellofemoral offset resulting in overstuffing of the patella resulted in decreased EME and increased PCMA and PCF during knee ROM. This may contribute to abnormal patellofemoral mechanics and a potential etiology for anterior knee pain and quadriceps weakness after TKA.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"491-496"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Cementless Patellar Implant Survivorship: A Systematic Review and Meta-Analysis of 3,005 Patellae.","authors":"Khaled A Elmenawi, Adrian E Gonzalez-Bravo, Larry J Prokop, Charles P Hannon, Matthew P Abdel, Nicholas A Bedard","doi":"10.1055/a-2509-3442","DOIUrl":"10.1055/a-2509-3442","url":null,"abstract":"<p><p>Historically, cementless patellar implants were fraught with issues of fixation and polyethylene wear. However, contemporary cementless patellar implants incorporate modern technologies for implant design and offer the potential for improved biological fixation and longevity. As such, an evaluation of the performance of modern cementless patellae is needed. The purpose of this study was to perform a systematic review and meta-analysis of contemporary cementless patellar implants used during primary total knee arthroplasty (TKA), with a particular focus on aseptic loosening of the patellar component. A systematic review of the literature was performed from January 2000 to February 22, 2024. We included all peer-reviewed studies that reported the number of revisions in patients who had cementless patellae placed in 2000 or later during primary TKA. Reviews and case reports were excluded. Out of 639 studies, 13 were included with a total of 3,005 cementless patellae analyzed. The mean patient age was 64 years and the mean body mass index (BMI) was 31 kg/m². Meta-analyses were performed to calculate the pooled revision rate per person-year of revision for aseptic loosening of the patellar component and revision for any patellar failure. Upon analysis of 13 studies involving a total of 3,005 cementless patellae, the revision rate for aseptic loosening of the patella was 0.2 per 1,000 person-years and the revision rate for any patellar failure was 1 per 1,000 person-years. Contemporary cementless patellar implants showed an overall revision rate of 1 per 1,000 person-years, demonstrating excellent longevity. The high survivorship, together with a low rate of loosening, show the utility and effectiveness of these implants. Given the nature of biologic fixation, these results are promising for long-term implant stability but additional follow-up is warranted.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"505-511"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}