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Is Pseudo-Patella Baja Really a Serious Complication of Total Knee Arthroplasty?
J Arthroplasty 2020; 35(2):557-562JA

Abstract

BACKGROUND

The available evidence on pseudo-patella baja (PPB) is limited. The purpose of this study is to investigate prospectively the occurrence of PPB after primary total knee arthroplasty and its clinical consequences in a large series of patients with a minimum follow-up of 2 years. PPB was defined as a patella distally displaced in relationship to the femoral trochlea with absence of patellar tendon shortening (Grelsamer RP. J Arthroplasty 2002;17:66-69) due to elevation of the joint line.

METHODS

This study is a prospective case series of 354 patients with a mean age of 71.7 (range 52-87) years. Clinical evaluation was performed by the Knee Society Scores (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short-Form 12-item (SF12), and range of motion. Patellar height was assessed by the Insall-Salvati and Blackburne-Peel ratios.

RESULTS

The mean follow-up was 3.6 (range 2.0-6.6) years. Postoperatively, 286 (80.7%) patients had a normal patellar height, 17 (4.8%) had true patella baja (TPB), and 51 (14.4%) had PPB. There were no significant differences between the 3 groups in mean KSS-function (P = .107), range of motion (P = .408), WOMAC-pain (P = .095), WOMAC-stiffness (P = .279), or SF12-mental (P = .363). Between normal and PPB groups, there were no significant differences in mean KSS-knee (P = .903), WOMAC-function (P = .294), or SF12-physical (P = .940). However, the TPB group had significantly lower mean KSS-knee (P = .031), WOMAC-function (P = .018), and SF12-physical (P = .005) as compared with either 2 other groups.

CONCLUSION

PPB was a relatively common finding, but no significant differences in terms of clinical outcomes were found as compared to patients with postoperative normal patellar height. TPB was infrequent, but these patients had significantly worse clinical outcomes than those with PPB or normal patellar height.

Authors+Show Affiliations

Department of Orthopaedic Surgery, General University Hospital of Elche, Alicante, Spain.Department of Biomedical and Dental Sciences and Morphofunctional Imaging, School of Orthopaedics and Traumatology, Universita degli Studi di Messina, Messina, Italy.Traumatology and Orthopaedia, Faculty of Medicine, Universidad Miguel Hernandez de Elche, Alicante, Spain.Department of Biomedical and Dental Sciences and Morphofunctional Imaging, School of Orthopaedics and Traumatology, Universita degli Studi di Messina, Messina, Italy.Department of Orthopaedic Surgery, General University Hospital of Elche, Alicante, Spain; Traumatology and Orthopaedia, Faculty of Medicine, Universidad Miguel Hernandez de Elche, Alicante, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31615703

Citation

Aguirre-Pastor, Alfredo, et al. "Is Pseudo-Patella Baja Really a Serious Complication of Total Knee Arthroplasty?" The Journal of Arthroplasty, vol. 35, no. 2, 2020, pp. 557-562.
Aguirre-Pastor A, Ortolá DJ, Lizaur-Utrilla A, et al. Is Pseudo-Patella Baja Really a Serious Complication of Total Knee Arthroplasty? J Arthroplasty. 2020;35(2):557-562.
Aguirre-Pastor, A., Ortolá, D. J., Lizaur-Utrilla, A., Rosa, M. A., & Lopez-Prats, F. A. (2020). Is Pseudo-Patella Baja Really a Serious Complication of Total Knee Arthroplasty? The Journal of Arthroplasty, 35(2), pp. 557-562. doi:10.1016/j.arth.2019.09.031.
Aguirre-Pastor A, et al. Is Pseudo-Patella Baja Really a Serious Complication of Total Knee Arthroplasty. J Arthroplasty. 2020;35(2):557-562. PubMed PMID: 31615703.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is Pseudo-Patella Baja Really a Serious Complication of Total Knee Arthroplasty? AU - Aguirre-Pastor,Alfredo, AU - Ortolá,David J, AU - Lizaur-Utrilla,Alejandro, AU - Rosa,Michele A, AU - Lopez-Prats,Fernando A, Y1 - 2019/09/23/ PY - 2019/06/04/received PY - 2019/08/10/revised PY - 2019/09/19/accepted PY - 2019/10/17/pubmed PY - 2019/10/17/medline PY - 2019/10/17/entrez KW - joint line elevation KW - patella baja KW - patella infera KW - pseudo-patella baja KW - total knee arthroplasty SP - 557 EP - 562 JF - The Journal of arthroplasty JO - J Arthroplasty VL - 35 IS - 2 N2 - BACKGROUND: The available evidence on pseudo-patella baja (PPB) is limited. The purpose of this study is to investigate prospectively the occurrence of PPB after primary total knee arthroplasty and its clinical consequences in a large series of patients with a minimum follow-up of 2 years. PPB was defined as a patella distally displaced in relationship to the femoral trochlea with absence of patellar tendon shortening (Grelsamer RP. J Arthroplasty 2002;17:66-69) due to elevation of the joint line. METHODS: This study is a prospective case series of 354 patients with a mean age of 71.7 (range 52-87) years. Clinical evaluation was performed by the Knee Society Scores (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short-Form 12-item (SF12), and range of motion. Patellar height was assessed by the Insall-Salvati and Blackburne-Peel ratios. RESULTS: The mean follow-up was 3.6 (range 2.0-6.6) years. Postoperatively, 286 (80.7%) patients had a normal patellar height, 17 (4.8%) had true patella baja (TPB), and 51 (14.4%) had PPB. There were no significant differences between the 3 groups in mean KSS-function (P = .107), range of motion (P = .408), WOMAC-pain (P = .095), WOMAC-stiffness (P = .279), or SF12-mental (P = .363). Between normal and PPB groups, there were no significant differences in mean KSS-knee (P = .903), WOMAC-function (P = .294), or SF12-physical (P = .940). However, the TPB group had significantly lower mean KSS-knee (P = .031), WOMAC-function (P = .018), and SF12-physical (P = .005) as compared with either 2 other groups. CONCLUSION: PPB was a relatively common finding, but no significant differences in terms of clinical outcomes were found as compared to patients with postoperative normal patellar height. TPB was infrequent, but these patients had significantly worse clinical outcomes than those with PPB or normal patellar height. SN - 1532-8406 UR - https://www.unboundmedicine.com/medline/citation/31615703/Is_Pseudo-Patella_Baja_Really_a_Serious_Complication_of_Total_Knee_Arthroplasty L2 - https://linkinghub.elsevier.com/retrieve/pii/S0883-5403(19)30914-3 DB - PRIME DP - Unbound Medicine ER -