None listed
Conditions
Brief summary
Background Proponents of minimally invasive knee replacements argue that retracting rather than everting the patella results in quicker postoperative recovery and improved function compared to the standard approach. We aimed to investigate this in a group of patients undergoing knee arthroplasty using a standard medial parapatellar approach. Methods In a prospective randomized double-blinded study sixty-six patients undergoing total knee arthroplasty through a standard medial parapatellar approach were assigned to either retraction or eversion of the patella. An independent observer assessed the Oxford knee score, the SF12 score, visual analog pain scores and range of motion data preoperatively, at three months and at one-year post surgery. Results Early (3 month) follow-up showed no difference in Oxford knee scores, SF12, visual analog pain scores or flexion. A statistically significant improvement in extension was found in the retraction group but this was not thought to be clinically significant. There was no difference in any outcomes at one year. There were two partial divisions of the patella tendon in the retraction group, but no patella related complications in the eversion group Conclusions Retracting rather than everting the patella during total knee arthroplasty results in no significant clinical benefit. There is an increased risk of damage to the patellar tendon, and reduced visualization of the lateral compartment.
Interventions
Patients randomized to patella eversion or retraction during total knee replacement. The standard handling of the patella during knee replacement is to evert or flip the patella over to expose the knee joint. In the retraction technique the patella is pulled to the side to expose the knee joint.
Sponsors
Sir Charles Gairdner Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
0 to No maximum
Healthy volunteers
No
Inclusion criteria
Male or female patients of any age requiring primary total knee arthroplasty under the care of the participating surgeons were included
Exclusion criteria
Exclusion criteria were body mass index over 40, nondislocatable patellae (eg secondary to patella baja or obesity), domiciled outside of Western Australia, and prior high tibial osteotomy or patella realignment procedures.
Outcome results
None listed