Patellar Rebar Augmentation in Revision Total Knee Arthroplasty. 2021

Edward J McPherson, and Sherif M Sherif, and Matthew V Dipane, and Armin Arshi
Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.

In revision total knee arthroplasty, osteolysis, mechanical abrasion, and infection may leave patellar bone stock severely attenuated with cavitary and/or segmental rim deficiencies that compromise fixation of patellar implant pegs. The purpose of this study was to retrospectively review the use of cortical "rebar" screws to augment cement fixation in revision patelloplasty. From 2006 to 2018, dorsal patellar rebar technique was used for patellar reconstruction in 128 of 1037 revision total knee arthroplasty cases (12.3%). Follow-up was achieved with serial radiographs and prospective comparison of Knee Society Scores (KSSs) for clinical outcome. Complications and implant failures requiring reoperation or modified rehabilitation were also assessed. Of the 128 patellar revisions performed using the rebar technique, 69 patients were women and 59 patients were men. The average age of the group was 69.5 years (range, 32-83 years). The mean follow-up of the cohort was 37 months (range, 13-109 months). The most common causes for revision were kinematic conflict, periprosthetic joint infection, and aseptic loosening. The median number of rebar screws used was 5 (range, 1-13). Preoperative KSSs for the study cohort averaged 50 (range, 0-90) At latest follow-up, mean KSS was 85 (range, 54-100). There were 4 patellar-related complications (3.1%) with no implant failures at study conclusion. Retrieval analysis revealed rigid fixation of the reconstructed patellar component in all cases. Patellar rebar screw augmentation is a useful technique when there are significant cavitary deficiencies and limited segmental rim deficiencies. This technique allows the surgeon to extend indications for patellar revision arthroplasty.

UI MeSH Term Description Entries
D007720 Knee Prosthesis Replacement for a knee joint. Knee Prostheses,Prostheses, Knee,Prosthesis, Knee
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010329 Patella The flat, triangular bone situated at the anterior part of the KNEE. Knee Cap,Kneecap,Knee Caps,Kneecaps,Patellas
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

Related Publications

Edward J McPherson, and Sherif M Sherif, and Matthew V Dipane, and Armin Arshi
November 2003, Clinical orthopaedics and related research,
Edward J McPherson, and Sherif M Sherif, and Matthew V Dipane, and Armin Arshi
September 2001, Orthopedics,
Edward J McPherson, and Sherif M Sherif, and Matthew V Dipane, and Armin Arshi
December 2013, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA,
Edward J McPherson, and Sherif M Sherif, and Matthew V Dipane, and Armin Arshi
May 2016, Der Orthopade,
Edward J McPherson, and Sherif M Sherif, and Matthew V Dipane, and Armin Arshi
January 1993, Clinical orthopaedics and related research,
Edward J McPherson, and Sherif M Sherif, and Matthew V Dipane, and Armin Arshi
June 2015, Knee surgery & related research,
Edward J McPherson, and Sherif M Sherif, and Matthew V Dipane, and Armin Arshi
November 1998, Clinical orthopaedics and related research,
Edward J McPherson, and Sherif M Sherif, and Matthew V Dipane, and Armin Arshi
January 2003, The Journal of bone and joint surgery. American volume,
Edward J McPherson, and Sherif M Sherif, and Matthew V Dipane, and Armin Arshi
June 2010, The Journal of arthroplasty,
Edward J McPherson, and Sherif M Sherif, and Matthew V Dipane, and Armin Arshi
December 2004, The Journal of arthroplasty,
Copied contents to your clipboard!