Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing

Background The radiolucent zones in the patella are sometimes observed in patients who have undergone total knee arthroplasty (TKA) without patellar resurfacing. On the basis of radiological findings from our clinical experience, we hypothesize that the pathogenesis of this lesion may be similar to that of the lesions of spontaneous osteonecrosis, and this lesion may be due to both osteoporosis and stress concentration. The present study aimed to determine the incidence of the radiolucent zone after TKA without patellar resurfacing. Moreover, the roles of osteoporosis and patellar morphology, which are related to the stress distribution in the patella, were also investigated. Methods We studied 48 knees of 38 patients who underwent primary TKA using the Genesis II prosthesis. Axial radiographs taken 1 year postoperatively were used to assess the incidence of the radiolucent zone. The World Health Organization fracture risk assessment tool (FRAX) score and the preoperative patellar facet angle were compared between patients with and without the radiolucent zones. Results Five patellae (10.4 %) showed the radiolucent zones postoperatively (the radiolucent group), whereas no such lesions were found in the remaining 43 patellae (the normal group). The major osteoporotic fracture risk of the radiolucent group calculated using the FRAX was 24.8 % and significantly higher than that in the normal group (14.7 %; p = 0.01). The average patellar facet angle in the radiolucent group was 123.6°, which was significantly smaller than that in the normal group (133.6°; p = 0.003). Discussion and conclusions The results of the present study suggest that both underlying osteoporosis and a steep patellar facet angle may play an important role in the pathogenesis of the radiolucent zones in patellae after TKA without patellar resurfacing. Patellar resurfacing may be considered, particularly in osteoporotic patients who have a steep patellar facet angle, to avoid the appearance of the postoperative radiolucent zone in the patella. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Takahashi, Atsushi [verfasserIn] Kamimura, Masayuki [verfasserIn] Sano, Hirotaka [verfasserIn] Kashiwaba, Mitsuhiro [verfasserIn] Ohnuma, Masahiro [verfasserIn] Itoi, Eiji [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2014

Schlagwörter:	Total Knee Arthroplasty Anterior Knee Pain Primary Total Knee Arthroplasty Patellar Height Patellar Resurface

Übergeordnetes Werk:	Enthalten in: Journal of orthopaedic science - Amsterdam : Elsevier, 1996, 19(2014), 4 vom: 26. Apr., Seite 558-563
Übergeordnetes Werk:	volume:19 ; year:2014 ; number:4 ; day:26 ; month:04 ; pages:558-563

Links:	Volltext

DOI / URN:	10.1007/s00776-014-0570-y

Katalog-ID:	SPR007763794

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520			\|a Background The radiolucent zones in the patella are sometimes observed in patients who have undergone total knee arthroplasty (TKA) without patellar resurfacing. On the basis of radiological findings from our clinical experience, we hypothesize that the pathogenesis of this lesion may be similar to that of the lesions of spontaneous osteonecrosis, and this lesion may be due to both osteoporosis and stress concentration. The present study aimed to determine the incidence of the radiolucent zone after TKA without patellar resurfacing. Moreover, the roles of osteoporosis and patellar morphology, which are related to the stress distribution in the patella, were also investigated. Methods We studied 48 knees of 38 patients who underwent primary TKA using the Genesis II prosthesis. Axial radiographs taken 1 year postoperatively were used to assess the incidence of the radiolucent zone. The World Health Organization fracture risk assessment tool (FRAX) score and the preoperative patellar facet angle were compared between patients with and without the radiolucent zones. Results Five patellae (10.4 %) showed the radiolucent zones postoperatively (the radiolucent group), whereas no such lesions were found in the remaining 43 patellae (the normal group). The major osteoporotic fracture risk of the radiolucent group calculated using the FRAX was 24.8 % and significantly higher than that in the normal group (14.7 %; p = 0.01). The average patellar facet angle in the radiolucent group was 123.6°, which was significantly smaller than that in the normal group (133.6°; p = 0.003). Discussion and conclusions The results of the present study suggest that both underlying osteoporosis and a steep patellar facet angle may play an important role in the pathogenesis of the radiolucent zones in patellae after TKA without patellar resurfacing. Patellar resurfacing may be considered, particularly in osteoporotic patients who have a steep patellar facet angle, to avoid the appearance of the postoperative radiolucent zone in the patella.
650		4	\|a Total Knee Arthroplasty \|7 (dpeaa)DE-He213
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700	1		\|a Ohnuma, Masahiro \|e verfasserin \|4 aut
700	1		\|a Itoi, Eiji \|e verfasserin \|4 aut
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author_variant	a t at m k mk h s hs m k mk m o mo e i ei
matchkey_str	article:14362023:2014----::ailcnznoteaelfloigoakeatrpatwt
hierarchy_sort_str	2014
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publishDate	2014
allfields	10.1007/s00776-014-0570-y doi (DE-627)SPR007763794 (SPR)s00776-014-0570-y-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.00 bkl 44.83 bkl Takahashi, Atsushi verfasserin aut Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The radiolucent zones in the patella are sometimes observed in patients who have undergone total knee arthroplasty (TKA) without patellar resurfacing. On the basis of radiological findings from our clinical experience, we hypothesize that the pathogenesis of this lesion may be similar to that of the lesions of spontaneous osteonecrosis, and this lesion may be due to both osteoporosis and stress concentration. The present study aimed to determine the incidence of the radiolucent zone after TKA without patellar resurfacing. Moreover, the roles of osteoporosis and patellar morphology, which are related to the stress distribution in the patella, were also investigated. Methods We studied 48 knees of 38 patients who underwent primary TKA using the Genesis II prosthesis. Axial radiographs taken 1 year postoperatively were used to assess the incidence of the radiolucent zone. The World Health Organization fracture risk assessment tool (FRAX) score and the preoperative patellar facet angle were compared between patients with and without the radiolucent zones. Results Five patellae (10.4 %) showed the radiolucent zones postoperatively (the radiolucent group), whereas no such lesions were found in the remaining 43 patellae (the normal group). The major osteoporotic fracture risk of the radiolucent group calculated using the FRAX was 24.8 % and significantly higher than that in the normal group (14.7 %; p = 0.01). The average patellar facet angle in the radiolucent group was 123.6°, which was significantly smaller than that in the normal group (133.6°; p = 0.003). Discussion and conclusions The results of the present study suggest that both underlying osteoporosis and a steep patellar facet angle may play an important role in the pathogenesis of the radiolucent zones in patellae after TKA without patellar resurfacing. Patellar resurfacing may be considered, particularly in osteoporotic patients who have a steep patellar facet angle, to avoid the appearance of the postoperative radiolucent zone in the patella. Total Knee Arthroplasty (dpeaa)DE-He213 Anterior Knee Pain (dpeaa)DE-He213 Primary Total Knee Arthroplasty (dpeaa)DE-He213 Patellar Height (dpeaa)DE-He213 Patellar Resurface (dpeaa)DE-He213 Kamimura, Masayuki verfasserin aut Sano, Hirotaka verfasserin aut Kashiwaba, Mitsuhiro verfasserin aut Ohnuma, Masahiro verfasserin aut Itoi, Eiji verfasserin aut Enthalten in Journal of orthopaedic science Amsterdam : Elsevier, 1996 19(2014), 4 vom: 26. Apr., Seite 558-563 (DE-627)300185928 (DE-600)1481657-X 1436-2023 nnns volume:19 year:2014 number:4 day:26 month:04 pages:558-563 https://dx.doi.org/10.1007/s00776-014-0570-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_31 GBV_ILN_95 GBV_ILN_150 GBV_ILN_151 GBV_ILN_187 GBV_ILN_267 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4307 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4338 44.00 ASE 44.83 ASE AR 19 2014 4 26 04 558-563
spelling	10.1007/s00776-014-0570-y doi (DE-627)SPR007763794 (SPR)s00776-014-0570-y-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.00 bkl 44.83 bkl Takahashi, Atsushi verfasserin aut Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The radiolucent zones in the patella are sometimes observed in patients who have undergone total knee arthroplasty (TKA) without patellar resurfacing. On the basis of radiological findings from our clinical experience, we hypothesize that the pathogenesis of this lesion may be similar to that of the lesions of spontaneous osteonecrosis, and this lesion may be due to both osteoporosis and stress concentration. The present study aimed to determine the incidence of the radiolucent zone after TKA without patellar resurfacing. Moreover, the roles of osteoporosis and patellar morphology, which are related to the stress distribution in the patella, were also investigated. Methods We studied 48 knees of 38 patients who underwent primary TKA using the Genesis II prosthesis. Axial radiographs taken 1 year postoperatively were used to assess the incidence of the radiolucent zone. The World Health Organization fracture risk assessment tool (FRAX) score and the preoperative patellar facet angle were compared between patients with and without the radiolucent zones. Results Five patellae (10.4 %) showed the radiolucent zones postoperatively (the radiolucent group), whereas no such lesions were found in the remaining 43 patellae (the normal group). The major osteoporotic fracture risk of the radiolucent group calculated using the FRAX was 24.8 % and significantly higher than that in the normal group (14.7 %; p = 0.01). The average patellar facet angle in the radiolucent group was 123.6°, which was significantly smaller than that in the normal group (133.6°; p = 0.003). Discussion and conclusions The results of the present study suggest that both underlying osteoporosis and a steep patellar facet angle may play an important role in the pathogenesis of the radiolucent zones in patellae after TKA without patellar resurfacing. Patellar resurfacing may be considered, particularly in osteoporotic patients who have a steep patellar facet angle, to avoid the appearance of the postoperative radiolucent zone in the patella. Total Knee Arthroplasty (dpeaa)DE-He213 Anterior Knee Pain (dpeaa)DE-He213 Primary Total Knee Arthroplasty (dpeaa)DE-He213 Patellar Height (dpeaa)DE-He213 Patellar Resurface (dpeaa)DE-He213 Kamimura, Masayuki verfasserin aut Sano, Hirotaka verfasserin aut Kashiwaba, Mitsuhiro verfasserin aut Ohnuma, Masahiro verfasserin aut Itoi, Eiji verfasserin aut Enthalten in Journal of orthopaedic science Amsterdam : Elsevier, 1996 19(2014), 4 vom: 26. Apr., Seite 558-563 (DE-627)300185928 (DE-600)1481657-X 1436-2023 nnns volume:19 year:2014 number:4 day:26 month:04 pages:558-563 https://dx.doi.org/10.1007/s00776-014-0570-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_31 GBV_ILN_95 GBV_ILN_150 GBV_ILN_151 GBV_ILN_187 GBV_ILN_267 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4307 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4338 44.00 ASE 44.83 ASE AR 19 2014 4 26 04 558-563
allfields_unstemmed	10.1007/s00776-014-0570-y doi (DE-627)SPR007763794 (SPR)s00776-014-0570-y-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.00 bkl 44.83 bkl Takahashi, Atsushi verfasserin aut Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The radiolucent zones in the patella are sometimes observed in patients who have undergone total knee arthroplasty (TKA) without patellar resurfacing. On the basis of radiological findings from our clinical experience, we hypothesize that the pathogenesis of this lesion may be similar to that of the lesions of spontaneous osteonecrosis, and this lesion may be due to both osteoporosis and stress concentration. The present study aimed to determine the incidence of the radiolucent zone after TKA without patellar resurfacing. Moreover, the roles of osteoporosis and patellar morphology, which are related to the stress distribution in the patella, were also investigated. Methods We studied 48 knees of 38 patients who underwent primary TKA using the Genesis II prosthesis. Axial radiographs taken 1 year postoperatively were used to assess the incidence of the radiolucent zone. The World Health Organization fracture risk assessment tool (FRAX) score and the preoperative patellar facet angle were compared between patients with and without the radiolucent zones. Results Five patellae (10.4 %) showed the radiolucent zones postoperatively (the radiolucent group), whereas no such lesions were found in the remaining 43 patellae (the normal group). The major osteoporotic fracture risk of the radiolucent group calculated using the FRAX was 24.8 % and significantly higher than that in the normal group (14.7 %; p = 0.01). The average patellar facet angle in the radiolucent group was 123.6°, which was significantly smaller than that in the normal group (133.6°; p = 0.003). Discussion and conclusions The results of the present study suggest that both underlying osteoporosis and a steep patellar facet angle may play an important role in the pathogenesis of the radiolucent zones in patellae after TKA without patellar resurfacing. Patellar resurfacing may be considered, particularly in osteoporotic patients who have a steep patellar facet angle, to avoid the appearance of the postoperative radiolucent zone in the patella. Total Knee Arthroplasty (dpeaa)DE-He213 Anterior Knee Pain (dpeaa)DE-He213 Primary Total Knee Arthroplasty (dpeaa)DE-He213 Patellar Height (dpeaa)DE-He213 Patellar Resurface (dpeaa)DE-He213 Kamimura, Masayuki verfasserin aut Sano, Hirotaka verfasserin aut Kashiwaba, Mitsuhiro verfasserin aut Ohnuma, Masahiro verfasserin aut Itoi, Eiji verfasserin aut Enthalten in Journal of orthopaedic science Amsterdam : Elsevier, 1996 19(2014), 4 vom: 26. Apr., Seite 558-563 (DE-627)300185928 (DE-600)1481657-X 1436-2023 nnns volume:19 year:2014 number:4 day:26 month:04 pages:558-563 https://dx.doi.org/10.1007/s00776-014-0570-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_31 GBV_ILN_95 GBV_ILN_150 GBV_ILN_151 GBV_ILN_187 GBV_ILN_267 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4307 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4338 44.00 ASE 44.83 ASE AR 19 2014 4 26 04 558-563
allfieldsGer	10.1007/s00776-014-0570-y doi (DE-627)SPR007763794 (SPR)s00776-014-0570-y-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.00 bkl 44.83 bkl Takahashi, Atsushi verfasserin aut Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The radiolucent zones in the patella are sometimes observed in patients who have undergone total knee arthroplasty (TKA) without patellar resurfacing. On the basis of radiological findings from our clinical experience, we hypothesize that the pathogenesis of this lesion may be similar to that of the lesions of spontaneous osteonecrosis, and this lesion may be due to both osteoporosis and stress concentration. The present study aimed to determine the incidence of the radiolucent zone after TKA without patellar resurfacing. Moreover, the roles of osteoporosis and patellar morphology, which are related to the stress distribution in the patella, were also investigated. Methods We studied 48 knees of 38 patients who underwent primary TKA using the Genesis II prosthesis. Axial radiographs taken 1 year postoperatively were used to assess the incidence of the radiolucent zone. The World Health Organization fracture risk assessment tool (FRAX) score and the preoperative patellar facet angle were compared between patients with and without the radiolucent zones. Results Five patellae (10.4 %) showed the radiolucent zones postoperatively (the radiolucent group), whereas no such lesions were found in the remaining 43 patellae (the normal group). The major osteoporotic fracture risk of the radiolucent group calculated using the FRAX was 24.8 % and significantly higher than that in the normal group (14.7 %; p = 0.01). The average patellar facet angle in the radiolucent group was 123.6°, which was significantly smaller than that in the normal group (133.6°; p = 0.003). Discussion and conclusions The results of the present study suggest that both underlying osteoporosis and a steep patellar facet angle may play an important role in the pathogenesis of the radiolucent zones in patellae after TKA without patellar resurfacing. Patellar resurfacing may be considered, particularly in osteoporotic patients who have a steep patellar facet angle, to avoid the appearance of the postoperative radiolucent zone in the patella. Total Knee Arthroplasty (dpeaa)DE-He213 Anterior Knee Pain (dpeaa)DE-He213 Primary Total Knee Arthroplasty (dpeaa)DE-He213 Patellar Height (dpeaa)DE-He213 Patellar Resurface (dpeaa)DE-He213 Kamimura, Masayuki verfasserin aut Sano, Hirotaka verfasserin aut Kashiwaba, Mitsuhiro verfasserin aut Ohnuma, Masahiro verfasserin aut Itoi, Eiji verfasserin aut Enthalten in Journal of orthopaedic science Amsterdam : Elsevier, 1996 19(2014), 4 vom: 26. Apr., Seite 558-563 (DE-627)300185928 (DE-600)1481657-X 1436-2023 nnns volume:19 year:2014 number:4 day:26 month:04 pages:558-563 https://dx.doi.org/10.1007/s00776-014-0570-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_31 GBV_ILN_95 GBV_ILN_150 GBV_ILN_151 GBV_ILN_187 GBV_ILN_267 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4307 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4338 44.00 ASE 44.83 ASE AR 19 2014 4 26 04 558-563
allfieldsSound	10.1007/s00776-014-0570-y doi (DE-627)SPR007763794 (SPR)s00776-014-0570-y-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.00 bkl 44.83 bkl Takahashi, Atsushi verfasserin aut Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The radiolucent zones in the patella are sometimes observed in patients who have undergone total knee arthroplasty (TKA) without patellar resurfacing. On the basis of radiological findings from our clinical experience, we hypothesize that the pathogenesis of this lesion may be similar to that of the lesions of spontaneous osteonecrosis, and this lesion may be due to both osteoporosis and stress concentration. The present study aimed to determine the incidence of the radiolucent zone after TKA without patellar resurfacing. Moreover, the roles of osteoporosis and patellar morphology, which are related to the stress distribution in the patella, were also investigated. Methods We studied 48 knees of 38 patients who underwent primary TKA using the Genesis II prosthesis. Axial radiographs taken 1 year postoperatively were used to assess the incidence of the radiolucent zone. The World Health Organization fracture risk assessment tool (FRAX) score and the preoperative patellar facet angle were compared between patients with and without the radiolucent zones. Results Five patellae (10.4 %) showed the radiolucent zones postoperatively (the radiolucent group), whereas no such lesions were found in the remaining 43 patellae (the normal group). The major osteoporotic fracture risk of the radiolucent group calculated using the FRAX was 24.8 % and significantly higher than that in the normal group (14.7 %; p = 0.01). The average patellar facet angle in the radiolucent group was 123.6°, which was significantly smaller than that in the normal group (133.6°; p = 0.003). Discussion and conclusions The results of the present study suggest that both underlying osteoporosis and a steep patellar facet angle may play an important role in the pathogenesis of the radiolucent zones in patellae after TKA without patellar resurfacing. Patellar resurfacing may be considered, particularly in osteoporotic patients who have a steep patellar facet angle, to avoid the appearance of the postoperative radiolucent zone in the patella. Total Knee Arthroplasty (dpeaa)DE-He213 Anterior Knee Pain (dpeaa)DE-He213 Primary Total Knee Arthroplasty (dpeaa)DE-He213 Patellar Height (dpeaa)DE-He213 Patellar Resurface (dpeaa)DE-He213 Kamimura, Masayuki verfasserin aut Sano, Hirotaka verfasserin aut Kashiwaba, Mitsuhiro verfasserin aut Ohnuma, Masahiro verfasserin aut Itoi, Eiji verfasserin aut Enthalten in Journal of orthopaedic science Amsterdam : Elsevier, 1996 19(2014), 4 vom: 26. Apr., Seite 558-563 (DE-627)300185928 (DE-600)1481657-X 1436-2023 nnns volume:19 year:2014 number:4 day:26 month:04 pages:558-563 https://dx.doi.org/10.1007/s00776-014-0570-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_31 GBV_ILN_95 GBV_ILN_150 GBV_ILN_151 GBV_ILN_187 GBV_ILN_267 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4307 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4338 44.00 ASE 44.83 ASE AR 19 2014 4 26 04 558-563
language	English
source	Enthalten in Journal of orthopaedic science 19(2014), 4 vom: 26. Apr., Seite 558-563 volume:19 year:2014 number:4 day:26 month:04 pages:558-563
sourceStr	Enthalten in Journal of orthopaedic science 19(2014), 4 vom: 26. Apr., Seite 558-563 volume:19 year:2014 number:4 day:26 month:04 pages:558-563
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Total Knee Arthroplasty Anterior Knee Pain Primary Total Knee Arthroplasty Patellar Height Patellar Resurface
dewey-raw	610
isfreeaccess_bool	false
container_title	Journal of orthopaedic science
authorswithroles_txt_mv	Takahashi, Atsushi @@aut@@ Kamimura, Masayuki @@aut@@ Sano, Hirotaka @@aut@@ Kashiwaba, Mitsuhiro @@aut@@ Ohnuma, Masahiro @@aut@@ Itoi, Eiji @@aut@@
publishDateDaySort_date	2014-04-26T00:00:00Z
hierarchy_top_id	300185928
dewey-sort	3610
id	SPR007763794
language_de	englisch
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On the basis of radiological findings from our clinical experience, we hypothesize that the pathogenesis of this lesion may be similar to that of the lesions of spontaneous osteonecrosis, and this lesion may be due to both osteoporosis and stress concentration. The present study aimed to determine the incidence of the radiolucent zone after TKA without patellar resurfacing. Moreover, the roles of osteoporosis and patellar morphology, which are related to the stress distribution in the patella, were also investigated. Methods We studied 48 knees of 38 patients who underwent primary TKA using the Genesis II prosthesis. Axial radiographs taken 1 year postoperatively were used to assess the incidence of the radiolucent zone. The World Health Organization fracture risk assessment tool (FRAX) score and the preoperative patellar facet angle were compared between patients with and without the radiolucent zones. Results Five patellae (10.4 %) showed the radiolucent zones postoperatively (the radiolucent group), whereas no such lesions were found in the remaining 43 patellae (the normal group). The major osteoporotic fracture risk of the radiolucent group calculated using the FRAX was 24.8 % and significantly higher than that in the normal group (14.7 %; p = 0.01). The average patellar facet angle in the radiolucent group was 123.6°, which was significantly smaller than that in the normal group (133.6°; p = 0.003). Discussion and conclusions The results of the present study suggest that both underlying osteoporosis and a steep patellar facet angle may play an important role in the pathogenesis of the radiolucent zones in patellae after TKA without patellar resurfacing. 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author	Takahashi, Atsushi
spellingShingle	Takahashi, Atsushi ddc 610 bkl 44.00 bkl 44.83 misc Total Knee Arthroplasty misc Anterior Knee Pain misc Primary Total Knee Arthroplasty misc Patellar Height misc Patellar Resurface Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing
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topic_title	610 ASE 44.00 bkl 44.83 bkl Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing Total Knee Arthroplasty (dpeaa)DE-He213 Anterior Knee Pain (dpeaa)DE-He213 Primary Total Knee Arthroplasty (dpeaa)DE-He213 Patellar Height (dpeaa)DE-He213 Patellar Resurface (dpeaa)DE-He213
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title	Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing
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title_full	Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing
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author_browse	Takahashi, Atsushi Kamimura, Masayuki Sano, Hirotaka Kashiwaba, Mitsuhiro Ohnuma, Masahiro Itoi, Eiji
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title_sort	radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing
title_auth	Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing
abstract	Background The radiolucent zones in the patella are sometimes observed in patients who have undergone total knee arthroplasty (TKA) without patellar resurfacing. On the basis of radiological findings from our clinical experience, we hypothesize that the pathogenesis of this lesion may be similar to that of the lesions of spontaneous osteonecrosis, and this lesion may be due to both osteoporosis and stress concentration. The present study aimed to determine the incidence of the radiolucent zone after TKA without patellar resurfacing. Moreover, the roles of osteoporosis and patellar morphology, which are related to the stress distribution in the patella, were also investigated. Methods We studied 48 knees of 38 patients who underwent primary TKA using the Genesis II prosthesis. Axial radiographs taken 1 year postoperatively were used to assess the incidence of the radiolucent zone. The World Health Organization fracture risk assessment tool (FRAX) score and the preoperative patellar facet angle were compared between patients with and without the radiolucent zones. Results Five patellae (10.4 %) showed the radiolucent zones postoperatively (the radiolucent group), whereas no such lesions were found in the remaining 43 patellae (the normal group). The major osteoporotic fracture risk of the radiolucent group calculated using the FRAX was 24.8 % and significantly higher than that in the normal group (14.7 %; p = 0.01). The average patellar facet angle in the radiolucent group was 123.6°, which was significantly smaller than that in the normal group (133.6°; p = 0.003). Discussion and conclusions The results of the present study suggest that both underlying osteoporosis and a steep patellar facet angle may play an important role in the pathogenesis of the radiolucent zones in patellae after TKA without patellar resurfacing. Patellar resurfacing may be considered, particularly in osteoporotic patients who have a steep patellar facet angle, to avoid the appearance of the postoperative radiolucent zone in the patella.
abstractGer	Background The radiolucent zones in the patella are sometimes observed in patients who have undergone total knee arthroplasty (TKA) without patellar resurfacing. On the basis of radiological findings from our clinical experience, we hypothesize that the pathogenesis of this lesion may be similar to that of the lesions of spontaneous osteonecrosis, and this lesion may be due to both osteoporosis and stress concentration. The present study aimed to determine the incidence of the radiolucent zone after TKA without patellar resurfacing. Moreover, the roles of osteoporosis and patellar morphology, which are related to the stress distribution in the patella, were also investigated. Methods We studied 48 knees of 38 patients who underwent primary TKA using the Genesis II prosthesis. Axial radiographs taken 1 year postoperatively were used to assess the incidence of the radiolucent zone. The World Health Organization fracture risk assessment tool (FRAX) score and the preoperative patellar facet angle were compared between patients with and without the radiolucent zones. Results Five patellae (10.4 %) showed the radiolucent zones postoperatively (the radiolucent group), whereas no such lesions were found in the remaining 43 patellae (the normal group). The major osteoporotic fracture risk of the radiolucent group calculated using the FRAX was 24.8 % and significantly higher than that in the normal group (14.7 %; p = 0.01). The average patellar facet angle in the radiolucent group was 123.6°, which was significantly smaller than that in the normal group (133.6°; p = 0.003). Discussion and conclusions The results of the present study suggest that both underlying osteoporosis and a steep patellar facet angle may play an important role in the pathogenesis of the radiolucent zones in patellae after TKA without patellar resurfacing. Patellar resurfacing may be considered, particularly in osteoporotic patients who have a steep patellar facet angle, to avoid the appearance of the postoperative radiolucent zone in the patella.
abstract_unstemmed	Background The radiolucent zones in the patella are sometimes observed in patients who have undergone total knee arthroplasty (TKA) without patellar resurfacing. On the basis of radiological findings from our clinical experience, we hypothesize that the pathogenesis of this lesion may be similar to that of the lesions of spontaneous osteonecrosis, and this lesion may be due to both osteoporosis and stress concentration. The present study aimed to determine the incidence of the radiolucent zone after TKA without patellar resurfacing. Moreover, the roles of osteoporosis and patellar morphology, which are related to the stress distribution in the patella, were also investigated. Methods We studied 48 knees of 38 patients who underwent primary TKA using the Genesis II prosthesis. Axial radiographs taken 1 year postoperatively were used to assess the incidence of the radiolucent zone. The World Health Organization fracture risk assessment tool (FRAX) score and the preoperative patellar facet angle were compared between patients with and without the radiolucent zones. Results Five patellae (10.4 %) showed the radiolucent zones postoperatively (the radiolucent group), whereas no such lesions were found in the remaining 43 patellae (the normal group). The major osteoporotic fracture risk of the radiolucent group calculated using the FRAX was 24.8 % and significantly higher than that in the normal group (14.7 %; p = 0.01). The average patellar facet angle in the radiolucent group was 123.6°, which was significantly smaller than that in the normal group (133.6°; p = 0.003). Discussion and conclusions The results of the present study suggest that both underlying osteoporosis and a steep patellar facet angle may play an important role in the pathogenesis of the radiolucent zones in patellae after TKA without patellar resurfacing. Patellar resurfacing may be considered, particularly in osteoporotic patients who have a steep patellar facet angle, to avoid the appearance of the postoperative radiolucent zone in the patella.
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title_short	Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing
url	https://dx.doi.org/10.1007/s00776-014-0570-y
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author2	Kamimura, Masayuki Sano, Hirotaka Kashiwaba, Mitsuhiro Ohnuma, Masahiro Itoi, Eiji
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On the basis of radiological findings from our clinical experience, we hypothesize that the pathogenesis of this lesion may be similar to that of the lesions of spontaneous osteonecrosis, and this lesion may be due to both osteoporosis and stress concentration. The present study aimed to determine the incidence of the radiolucent zone after TKA without patellar resurfacing. Moreover, the roles of osteoporosis and patellar morphology, which are related to the stress distribution in the patella, were also investigated. Methods We studied 48 knees of 38 patients who underwent primary TKA using the Genesis II prosthesis. Axial radiographs taken 1 year postoperatively were used to assess the incidence of the radiolucent zone. The World Health Organization fracture risk assessment tool (FRAX) score and the preoperative patellar facet angle were compared between patients with and without the radiolucent zones. Results Five patellae (10.4 %) showed the radiolucent zones postoperatively (the radiolucent group), whereas no such lesions were found in the remaining 43 patellae (the normal group). The major osteoporotic fracture risk of the radiolucent group calculated using the FRAX was 24.8 % and significantly higher than that in the normal group (14.7 %; p = 0.01). The average patellar facet angle in the radiolucent group was 123.6°, which was significantly smaller than that in the normal group (133.6°; p = 0.003). Discussion and conclusions The results of the present study suggest that both underlying osteoporosis and a steep patellar facet angle may play an important role in the pathogenesis of the radiolucent zones in patellae after TKA without patellar resurfacing. Patellar resurfacing may be considered, particularly in osteoporotic patients who have a steep patellar facet angle, to avoid the appearance of the postoperative radiolucent zone in the patella.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Total Knee Arthroplasty</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Anterior Knee Pain</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Primary Total Knee Arthroplasty</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Patellar Height</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Patellar Resurface</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Kamimura, Masayuki</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Sano, Hirotaka</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Kashiwaba, Mitsuhiro</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ohnuma, Masahiro</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Itoi, Eiji</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">Journal of orthopaedic science</subfield><subfield code="d">Amsterdam : Elsevier, 1996</subfield><subfield code="g">19(2014), 4 vom: 26. 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Radiolucent zone of the patella following total knee arthroplasty without patellar resurfacing

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