Abstract:Objective To investigate the effect of lateral patellar facetectomy on anterior knee pain after total knee arthroplasty (TKA) .Methods Clinical data of 528 patients who underwent TKA in Beijing Chao-Yang Hospital from March 2015 to June 2018 were retrospectively analyzed, including 96 males and 432 females, aged 54-83 (68.27±7.29) years. The patients were divided into the osteophyte removal (OR) group, which included 274 patients who underwent OR in the patella, and the lateral patellar facetectomy (LF) group, which was composed of 254 patients who underwent LF. Baseline data, such as age, sex distribution, body mass index, operation time, and hip-knee-ankle angle, were recorded. Clinical outcomes were evaluated on the basis of patellar tilting angle, Blackburne-Peel (BP) index, Laurin angle, patellofemoral index, American Knee Society Score (KSS), range of motion, and incidence of anterior knee pain.Results Baseline information between the two groups was insignificantly different (all P values>0.05). Laurin angle, BP index, patellar tilting angle, and patellofemoral index were not statistically different (all P values>0.05) between the two groups. However, postoperative patellar tilting angle (15.00°±1.70° versus 13.88°±2.87°), Laurin angle (6.80°±4.94° versus 10.72°±4.37°), and patellofemoral index (2.02±0.43 versus 1.56±0.46) were significantly different from the preoperative data (t=5.324, 9.672, 11.995, all P values<0.01). Preoperative and postoperative Laurin angle, patellar tilting angle, and patellofemoral index in the OR group were statistically different (t=2.917, 4.861, 12.244, all P values<0.05). Meanwhile, postoperative BP index was similar to preoperative BP index (P>0.05). Laurin angle was significantly different before and after operation (t=8.928, P<0.05). KSS and range of motion were significantly improved postoperation in both groups (all P values<0.05). By contrast, the preoperative and postoperative KSS and range of motion of the two groups were not statistically different (all P values>0.05). The incidence of anterior knee pain in the LF group was 0.8% (2/254), which was significantly lower than that in the OR group (5.5%, 15/274; χ2=7.995, P<0.05).Conclusions Compared with OR in the patella, LF can achieve better postoperative imaging parameters, better postoperative functions, and lower incidence of anterior knee pain
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