Increased incidence of patella baja after total knee arthroplasty revision for infection

The incidence of patella baja in total knee arthroplasty (TKA) revisions for aseptic and septic causes is not well defined. We retrospectively reviewed 101 mobile-bearing TKA revisions performed between 2003 and 2009. Aseptic (n=67) and septic (n=34) revisions were compared for patella baja. A nonar...

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Published inThe American journal of orthopedics (Belle Mead, N.J.) Vol. 43; no. 12; p. 562
Main Authors Chen, Antonia F, Tetreault, Matthew W, Levicoff, Eric A, Fedorka, Catherine J, Rothenberg, Adam C, Klatt, Brian A
Format Journal Article
LanguageEnglish
Published United States 01.12.2014
Subjects
Aged
Arthroplasty, Replacement, Knee - adverse effects
Cohort Studies
Female
Humans
Incidence
Joint Diseases - etiology
Joint Diseases - surgery
Knee Joint - surgery
Male
Middle Aged
Patella - diagnostic imaging
Patella - pathology
Prosthesis Failure
Prosthesis-Related Infections - etiology
Prosthesis-Related Infections - surgery
Radiography
Reoperation
Retrospective Studies
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Summary:The incidence of patella baja in total knee arthroplasty (TKA) revisions for aseptic and septic causes is not well defined. We retrospectively reviewed 101 mobile-bearing TKA revisions performed between 2003 and 2009. Aseptic (n=67) and septic (n=34) revisions were compared for patella baja. A nonarticulating spacer was used as the initial treatment for infected cases. The Insall-Salvati ratio was radiographically measured before surgery (preexplant for septic revisions) and at latest follow-up (postreplant for septic revisions). Mean (SD) Insall-Salvati ratio did not differ between groups before surgery, 1.00 (0.25) for aseptic and 0.96 (0.22) for septic, but differed significantly after surgery, 0.99 (0.23) for aseptic and 0.77 (0.24) for septic. After correcting for preoperative patellar height, there was a statistically significant postoperative difference between aseptic cases, 1.09 (0.19), and septic cases, 0.82 (0.21). There was also a significant difference in mean (SD) postoperative range of motion (ROM) between aseptic cases, 108.0° (20.7°), and septic cases, 92.2° (34.6°), and decreased ROM between cases with patella baja, 95.1° (31.6°) and cases without patella baja, 106.8° (23.6°). TKA revisions done for septic causes using a nonarticulating spacer resulted in a higher incidence of patella baja and decreased ROM.
ISSN:1934-3418