Patellar component design influences size selection and coverage

• Published in: The knee Vol. 24; no. 2; pp. 460 - 467
• Main Authors: Yang, Charlie C, Dennis, Douglas A, Davenport, Patrick G, Kim, Raymond H, Miner, Todd M, Johnson, Derek R, Laz, Peter J
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-03-2017; Elsevier Limited
• Subjects: Aged; Arthroplasty (knee); Arthroplasty, Replacement, Knee - instrumentation; Bony coverage; Decision making; Female; Fractures; Hospitals; Humans; Implant design; Implant size; Joint Diseases - surgery; Joint surgery; Knee; Knee Joint - surgery; Knee Prosthesis; Male; Middle Aged; Orthopedics; Pain; Patella; Patella - surgery; Patellar component; Patellofemoral; Patients; Prostheses; Prosthesis Design; Royalties; Skin & tissue grafts; Statistical analysis; Studies; Surgeons; Symmetry; Total knee replacement; Transplants & implants; Patellar component; Implant size; Patellofemoral; Total knee replacement; Implant design; Bony coverage
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2016.10.013

Abstract Background Patellofemoral (PF) complications following total knee arthroplasty continue to occur. Outcomes are influenced by implant design, size and alignment in addition to patient factors. The objective of this study was to assess the effect of implant design, specifically round versus oval dome patellar components, on size selected and bony coverage in a population of 100 patients. Methods Intraoperative assessments of patella component size were performed using surgical guides for round and oval designs. Digital images of the resected patellae with and without guides were calibrated and analyzed to measure bony coverage. Lastly, the medial–lateral location of the median ridge was assessed in the native patella and compared to the positioning of the apex of the patellar implants. Results In 82% of subjects, a larger oval implant was selected compared to a round. Modest, but statistically significant, differences were observed in selected component coverage of the resected patella: 82.7% for oval versus 80.9% for round. Further, positioning of the apex of oval patellar components reproduced the median ridge of the native patella more consistently than for round components. Conclusions These findings characterized how implant design influenced size selection and coverage in a population of patients. The ability to “upsize” with oval dome components led to increases in bony coverage and better replication of the median ridge compared to round components. Quantifying the interactions between implant design, sizing and coverage for a current implant system in a population of patients supports surgical decision-making and informs the design of future implants.