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| Name | Class |
|---|---|
| Ain Shams University | OTHER |
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Total knee arthroplasty (TKA ) is the gold standard treatment for advanced knee osteoarthritis. only 85% (75% to 92%) of patients with total knee arthroplasty are satisfied with their operations and 30% develops patellofemoral complications.
Numerous biomechanical studies suggest that patellofemoral tracking is not always restored to physiological values, because the prosthetic trochlea may differ from the native trochlea. no study has been con-ducted to investigate the thickness of the trochlear groove and its effect on the outcome of Total knee replacement (TKR), So many people has different measurements of trochlear thickness which may affect Patellofemoral joint (PFJ) so knowing of native trochlear thickness in patients with KNEE Osteoarthritis (OA) can affect the outcomes of total knee arthroplasty.
Total knee arthroplasty is the gold standard treatment for advanced knee osteoarthritis. In spite of the great advance in the prosthesis design, surgical techniques and rehabilitation programs, only 85% (75% to 92%) of patients with total knee arthroplasty are satisfied with their operations and 30% develops patellofemoral complications. Patellofemoral complications after TKR are usually caused by multiple factors related to surgical technique (e.g., implant positioning and sizing, soft-tissue balancing, patellar resurfacing, etc.) and implant design (e.g., trochlear thickness, sagittal curvature, patellar component shape).
Numerous biomechanical studies suggest that patellofemoral tracking is not always restored to physiological values, because the prosthetic trochlea may differ from the native trochlea.
Theoretically decreasing of contact area distance of trochlea might increase the contact pressure in the patellofemoral joint. The increased contact pressure will elevate the stress in the subchondral bone of the patellofemoral joint, which is hypothesized to be a cause of patellofemoral pain.
A mechanical experiment was performed in an attempt to analyze the influence of thickening of the patella on the knee extension movement. The measurement show that anterior advancement of the extensor apparatus at the level of the patella gives a mechanical advantage, enabling the quadriceps to extend the knee with the use of less force. so increase thickness of patella affects the quadriceps function but no study has been shown the effect of trochlear thickness on quadriceps or patellofemoral joint.
Nonetheless, no study has been con-ducted to investigate the thickness of the trochlear groove and its effect on the outcome of TKR, So many people has different measurements of trochlear thickness which may affect PFJ so knowing of native trochlear thickness in patients with KNEE OA can affect the outcomes of total knee arthroplasty.
Preoperative and postoperative radiography (CT scan) can provide an adequate measurement of trochlear thickness which will help in understanding more about PFJ and its effect in the total knee replacement.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| trochlear thickness change | Radiological Assessment of trochlear thickness of PFJ in primary TKR by preoperative and postoperative CT scan. and observing Effects of Ct Different measures changes in trochlear thickness on short term TKR outcomes |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CT trochlear thickness change | Other | Preoperative and postoperative CT scan measuring trochlear thickness of PFJ was defined as distance from deepest part of trochlea and line tangential to the anterior aspect of the femoral cortex. It was assessed on the sagittal cuts. CT images will be viewed using Sante DICOM viewer version 5.4.2 and image fusion will be done using Overlay multiple image software. Two observers will measure the angles and the intraobserver and interobserver reliabilities will be assessed for consistency by the intraclass correlation coefficient (ICC) and reliability coefficient using the SPSS software |
| Measure | Description | Time Frame |
|---|---|---|
| Functional outcome | knee society score (KSS). | preoperative and six months postoperatively |
| Functional Outcome | Patellofemoral score (Barlett patellofemoral score). | preoperative and six months postoperatively |
| Functional Outcome | ROM | preoperative and six months postoperatively |
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Inclusion Criteria:
Exclusion Criteria:
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patients with primary knee osteoarthritis
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| Name | Affiliation | Role |
|---|---|---|
| Ibrahim B Anis, MS | Ain Shams University | Principal Investigator |
| Wael S Abd El Mageed, MD | Ain Shams University | Study Director |
| Sherif M El Sayed, MD | Ain Shams University | Study Director |
| Zeiad M Zakaria, MD | Ain Shams University | Study Director |
| Mohmed E Awad, MD | Ain Shams University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ain Sahms University | Cairo | Abbasia | 11517 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 8425373 | Result | Ranawat CS, Flynn WF Jr, Saddler S, Hansraj KK, Maynard MJ. Long-term results of the total condylar knee arthroplasty. A 15-year survivorship study. Clin Orthop Relat Res. 1993 Jan;(286):94-102. | |
| 7798101 | Result | Healy WL, Wasilewski SA, Takei R, Oberlander M. Patellofemoral complications following total knee arthroplasty. Correlation with implant design and patient risk factors. J Arthroplasty. 1995 Apr;10(2):197-201. doi: 10.1016/s0883-5403(05)80127-5. |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| 2140459 | Result | Dejour H, Walch G, Neyret P, Adeleine P. [Dysplasia of the femoral trochlea]. Rev Chir Orthop Reparatrice Appar Mot. 1990;76(1):45-54. French. |
| D012216 |
| Rheumatic Diseases |