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Patients undergoing TKR for OA may benefit from retained infrapatellar fat pad
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VIENNA — In patients who undergo total knee replacement, retention of the infrapatellar fat pad is associated with better functional outcomes and less postoperative pain, according to a study presented here during the Free Papers Award Session for Orthopaedics at the 18th EFORT Annual Congress in Vienna.
In the randomized controlled study, researchers enrolled 66 patients listed for primary total knee replacement (TKR) for osteoarthritis. The investigators excluded patients undergoing revision surgery, surgery for other conditions, patients who had incurred fractures of the knee and patients with confirmed intra-articular infections. A strict standardized protocol was used in terms of the extent of soft tissue dissection. Patients were assessed using the Oxford Knee Score, KOOS score, Lysholm score, Kujala score and VAS pain score preoperatively, as well as at 3 months, 12 months and 24 months postoperatively. A single-blinded randomization was used regarding the removal of the infrapatellar fat pad. The two groups had similar demographics. The fat pad-removed group had an average patient age of 67 years, with a male/female ratio of 1:1.3. The fat pad-retained group had an average of age of 68 years, with a male/female ratio of 1:1. Moreover, the levels of preoperative function and pain were similar between the two groups.
At 3 months after TKR, the two groups showed no significant differences across the measures used. At 12 months, however, patients who had their infrapatellar fat pads retained demonstrated more favorable performances across the measures vs. those whose fat pads had been removed. The KOOS scores between the two groups significantly favored those in the fat pad-retained group. Similar results were observed at 24 months postoperatively.
“This trial establishes that the way we undertake knee replacements can affect patient outcomes,” presenter Anthony Howard, PhD, NIHR Clinical Lecturer in Trauma & Orthopaedic Surgery at Leeds Teaching Hospitals NHS Trust, School of Medicine at University of Leeds, told Orthopaedics Today Europe. “It reinforces why research in surgical techniques is important, as it gives the chance to improve patient outcomes.” – by Jennifer Byrne
- Reference:
- Howard A, et al. Paper #606. Presented at 18th EFORT Annual Congress; 31 May - 2 June 2017; Vienna.
- For more information:
- Anthony Howard, PhD, can be reached at Leeds University, Leeds, LS2 9JT, United Kingdom; email: anthonyjhoward@aol.com.
Disclosure: Howard reports no relevant financial disclosures.