Study finds high rates of survivorship in TKA with cemented all-polyethylene patellae
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Published results showed a 93.3% survivorship free from any aseptic patellar complication at 20 years in patients who underwent total knee arthroplasty with a cemented all-polyethylene patellar component.
To determine the risk of aseptic patellar complications after primary TKA, Afton K. Limberg, BS, and investigators at the Mayo Clinic, Rochester, analyzed data from 27,192 primary TKAs with cemented all-polyethylene patellar components at a single institution from 1977 to 2015. Outcome measures included any aseptic patellar reoperation, revision, loosening, maltracking, instability, wear, fracture, and clunk or crepitus.
At median follow-up of 7 years, 977 knees with all-polyethylene patellar components developed patellar complications. Survivorship free from any aseptic patellar complication was 93.3% at 20 years, while survivorship free from any aseptic patellar reoperation was 97.3%, and survivorship free from any aseptic patellar revision was 97.4%.
“Notably, in patients who had surgery in years 2000 to 2015, during which time modern designs and surgical techniques were used, the 15-year survivorship free from any aseptic patellar complication (95.7%), any aseptic patellar reoperation (99.2%), and any aseptic patellar revision (99.3%) was excellent,” the authors wrote.
Factors that increased risk for patellar complications were male sex, age younger than 65 years and BMI of 30 kg/m2 or greater.
Overall, posterior-stabilized (PS) designs were associated with fewer patellar reoperations and revisions; however, these designs were also associated with higher risk of patellar clunk or crepitus.
“This increased risk is probably due to increased utilization of PS designs after the year 2000,” the authors wrote. “Conversely, the risks of patellar loosening, instability and wear were decreased with PS designs.”
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