Influence of Patella Height on Total Knee Arthroplasty: Outcomes and Survival

Romain Gaillard, Christopher Bankhead, Nicolaas Budhiparama, Cécile Batailler, Elvire Servien, Sébastien Lustig

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)

Abstract

Background: The aim of this study is to assess clinical results of total knee arthroplasty (TKA) with pre-operative patella alta or patella baja, compared to TKA with pre-operative normal patellar height. Methods: Patella height was measured using the Blackburne-Peel (BP) method in an initial, prospective cohort of 4103 TKAs performed at a single center. Three groups were defined: normal patella height (0.54 < BP index ≤ 1.06), patella alta (BP index >1.06), and patella baja (BP index ≤0.54). Pre-operative and post-operative clinical and radiological characteristics were collected and compared. All prostheses used a system of posterior stabilization by a third condyle. The primary outcome measure was the post-operative Knee Society Score. Statistical analysis was performed using Student's t-test and chi-squared test, with P <.05. Results: Two hundred twenty-three TKAs with pre-operative patella alta, 307 TKAs with pre-operative patella baja, and 2248 with pre-operative normal patella height, mean follow-up 39.3 months (range 24-239), were ultimately included. Post-operatively, there was no difference between the 3 groups in terms of Knee Society Score (knee and function scores). Patella baja statistically decreased the maximal flexion (118.2° vs 115.5° P =.002) and increased the rate of patellar fracture (0.9% vs 2%, P =.05). Finally, survival rates were similar in the 3 groups with each above 91% (±2%) at 10 years. Conclusion: Clinical and radiological results for TKAs with pre-operative patella alta and patella baja were comparable to TKAs with a normal pre-operative patellar height. Risk of post-operative patellar fracture increased for patients with pre-operative patella baja.

Original languageEnglish
Pages (from-to)469-477
Number of pages9
JournalJournal of Arthroplasty
Volume34
Issue number3
DOIs
Publication statusPublished - Mar 2019
Externally publishedYes

Keywords

  • Blackburne-Peel index
  • KSS
  • patella alta
  • patella baja
  • total knee arthroplasty

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