Implant survival after TKA similar in patients with OA, previous patella fractures
LAS VEGAS — Patients who underwent total knee arthroplasty and had a previous patella fracture had implant survival rates similar to patients who underwent total knee arthroplasty with osteoarthritis, according to research presented at the American Academy of Orthopaedic Surgeons Annual Meeting, here.
Matthew Houdek, MD, and colleagues retrospectively analyzed 122 patients (mean age: 66 years; mean follow-up: 6 years) who underwent TKA and had a previous patella fracture between 1990 and 2013. These patients were compared for implant survival with 20,474 patients with osteoarthritis (OA) who underwent TKA during the same span. Although most fractures were treated surgically, 40% of patients had fixation hardware removed prior to TKA, whereas 86% underwent patellar resurfacing. Complications and Kaplan-Meier survivorship were evaluated.
Among patients in the patellar fracture cohort, survival rates at 5, 10 and 15 years postoperatively were 93%, 91% and 86%, respectively, compared with 97%, 93% and 86%, respectively, in the OA group.
Those in the patella fracture cohort exhibited elevated rates of arthrofibrosis, necessitation of manipulation under anesthesia and patellar hardware loosening, according to the researchers.
“Historically, patellar fractures were demonstrated to be associated with increased rates of postoperative complications before and after arthroplasty,” Houdek said during his presentation. Risk of reoperation was highest in patients older than 60 years of age. Revision TKA took place in only 7% of cases at a mean time of 2.9 years, according to the researchers. – by Christian Ingram
Houdek M, et al. Paper #234. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 24-28, 2015; Las Vegas.
Disclosure: Houdek reports no relevant financial disclosures.