The Journal of arthroplasty · 2026
Patella Resurfacing Is Associated With Improving Six-Month Outcomes in Kinematically Aligned Total Knee Arthroplasty: A Propensity Score-Matched Analysis.
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Ng Yong, Chen Jiawei, Jared Chua Hong Yu, Jin Tay Darren Keng, Pang Hee Nee, Yeo Seng-Jin, Lincoln Liow Ming Han
Аннотация
BACKGROUND: Kinematic alignment (KA) seeks to restore each patient's native knee anatomy. Limited research compares functional outcomes between KA robotic-assisted total knee arthroplasty (rTKA) and conventional KA-TKA (cTKA). This study examined differences in early and 6-month functional outcomes between imageless, table-mounted rTKA and cTKA.
METHODS: We conducted a retrospective, propensity score-matched cohort study including 291 primary KA-TKAs from January 2018 to October 2024. In cTKA, patella resurfacing was routinely performed, but not in rTKA. There were 98 KA-rTKA patients matched with 98 KA-cTKA patients. Early postoperative (i.e., static/dynamic pain score and ambulation distance) and 6-month functional outcomes (e.g., Knee Society Function and Knee score, Oxford Knee Score [OKS], and Short Form-36) were analyzed. Group differences in functional scores, proportion attaining minimal clinically important difference, and coronal plane alignment of the knee (CPAK) restoration were analyzed at a 95% confidence level, with significance at P < 0.05.
RESULTS: At 6 months, cTKA showed significantly improved Knee Society Function score (P = 0.049), Knee Society Knee score (P < 0.001), and OKS (P = 0.015). The cTKA trended toward higher Short Form-36 outcome measures, with significant differences in physical function (P = 0.002), role physical (P = 0.034), and physical component summary (P = 0.002). A larger proportion of cTKA patients achieved minimal clinically important difference for OKS (P = 0.008), physical function (P = 0.004), role function (P = 0.006), and physical component summary (P = 0.036). Similar CPAK restoration rates between rTKA and cTKA were noted (P = 0.934), with more accurate restoration in lateral distal femoral angle (84.8 versus 83.9%) and medial proximal tibial angle (81.9 versus 68.2%) for rTKA.
CONCLUSIONS: Despite similar CPAK restoration rates and higher accuracy in restoring CPAK tibial and femoral resections, cTKA demonstrated superior functional outcomes at six months. These findings suggest that patella resurfacing is associated with improved 6-month outcomes in KA-TKA.
METHODS: We conducted a retrospective, propensity score-matched cohort study including 291 primary KA-TKAs from January 2018 to October 2024. In cTKA, patella resurfacing was routinely performed, but not in rTKA. There were 98 KA-rTKA patients matched with 98 KA-cTKA patients. Early postoperative (i.e., static/dynamic pain score and ambulation distance) and 6-month functional outcomes (e.g., Knee Society Function and Knee score, Oxford Knee Score [OKS], and Short Form-36) were analyzed. Group differences in functional scores, proportion attaining minimal clinically important difference, and coronal plane alignment of the knee (CPAK) restoration were analyzed at a 95% confidence level, with significance at P < 0.05.
RESULTS: At 6 months, cTKA showed significantly improved Knee Society Function score (P = 0.049), Knee Society Knee score (P < 0.001), and OKS (P = 0.015). The cTKA trended toward higher Short Form-36 outcome measures, with significant differences in physical function (P = 0.002), role physical (P = 0.034), and physical component summary (P = 0.002). A larger proportion of cTKA patients achieved minimal clinically important difference for OKS (P = 0.008), physical function (P = 0.004), role function (P = 0.006), and physical component summary (P = 0.036). Similar CPAK restoration rates between rTKA and cTKA were noted (P = 0.934), with more accurate restoration in lateral distal femoral angle (84.8 versus 83.9%) and medial proximal tibial angle (81.9 versus 68.2%) for rTKA.
CONCLUSIONS: Despite similar CPAK restoration rates and higher accuracy in restoring CPAK tibial and femoral resections, cTKA demonstrated superior functional outcomes at six months. These findings suggest that patella resurfacing is associated with improved 6-month outcomes in KA-TKA.