Is Further Treatment Necessary for Patellar Crepitus After Total Knee Arthroplasty? View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2013-02

AUTHORS

Bo-Hyun Hwang, Chang-Hyun Nam, Kwang-Am Jung, Alvin Ong, Su-Chan Lee

ABSTRACT

BACKGROUND: Patellar crepitus may occur with posterior-stabilized (PS) TKAs. Several studies have suggested numerous etiologies of patellar crepitus after PS-TKA with patellar resurfacing. However, it is unclear whether and to what degree crepitus influences pain and function without or with patellar resurfacing. QUESTIONS/PURPOSES: We therefore determined (1) the frequency of crepitus; (2) which factors predicted the occurrence of crepitus; and (3) whether crepitus influenced pain and function. METHODS: We retrospectively reviewed 41 patients (54 knees) with painful or painless patellar crepitus after primary PS-TKAs without patellar resurfacing performed from 2007 to 2008. These patients were compared with a group of 73 patients (94 knees) without patellar crepitus matched for age, sex, and BMI. The minimum followup was 2 years (mean, 2.8 years; range, 2-4.5 years). RESULTS: Five (9%) of the 54 knees with patellar crepitus also had peripatellar pain. Mean time from primary TKA to the onset of patellar crepitus was 4 months. All patients in the patellar crepitus group were asymptomatic within 1 year of onset of symptoms without additional surgical treatment. The development of patellar crepitus was associated with an Outerbridge patellar cartilage Grade 4 (odds ratio [OR], 11.9; 95% CI, 2.2-65.3) and joint line elevation (OR, 5.1; 95% CI, 1.9-8.6). CONCLUSIONS: Patellar crepitus is typically benign and self-limited. We continue not to resurface arthritic patellae and counsel patients with patellar crepitus that their symptoms will improve without intervention. LEVEL OF EVIDENCE: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. More... »

PAGES

606-612

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11999-012-2634-7

DOI

http://dx.doi.org/10.1007/s11999-012-2634-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1038956605

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23179113


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