Abstract：
BACKGROUND: Patella resurfacing remains controversial in primary total knee arthroplasty (TKA).The aim of this study was to investigate if there was a difference in revision rate and reason for revision within 8 years after single brand primary cemented TKA with or without patella resurfacing, using data from the Dutch Arthroplasty Register.
METHODS: All primary TKA surgeries with a posterior stabilized cemented primary NexGen®, between 2010 and 2013 with diagnosis osteoarthritis were analyzed (n = 5911). Multivariate cox regression analyses were performed to analyze differences in revision rate between TKA with or without patella component, and was adjusted for age and previous surgery.
RESULTS: Of 5911 TKA surgeries, 4795 were performed without patella resurfacing (81.1%) and 1116 with patella resurfacing (18.9%). There was a significant difference in patellar problems as reason for revision between patients after primary TKA with patella resurfacing (9.3%) and without patella resurfacing (29.9%) (p = 0.01). This was mostly caused by patellar pain (28.0%). There was no significant difference in cumulative revision rate within between TKA with patella resurfacing and without patella resurfacing.
CONCLUSIONS: In conclusion, 30% of patients who need revision surgery after TKA using NexGen® PS without patella resurfacing the reason for revision is patella related problems, compared to 9% after TKA NexGen® PS with patella resurfacing. There was no difference in cumulative incidence of revision after primary surgery of all TKA\'s using NexGen® PS with or without patella. To reduce the probability of reoperation for patella related problems, our data suggest the patella should be resurface during primary TKA.
METHODS: All primary TKA surgeries with a posterior stabilized cemented primary NexGen®, between 2010 and 2013 with diagnosis osteoarthritis were analyzed (n = 5911). Multivariate cox regression analyses were performed to analyze differences in revision rate between TKA with or without patella component, and was adjusted for age and previous surgery.
RESULTS: Of 5911 TKA surgeries, 4795 were performed without patella resurfacing (81.1%) and 1116 with patella resurfacing (18.9%). There was a significant difference in patellar problems as reason for revision between patients after primary TKA with patella resurfacing (9.3%) and without patella resurfacing (29.9%) (p = 0.01). This was mostly caused by patellar pain (28.0%). There was no significant difference in cumulative revision rate within between TKA with patella resurfacing and without patella resurfacing.
CONCLUSIONS: In conclusion, 30% of patients who need revision surgery after TKA using NexGen® PS without patella resurfacing the reason for revision is patella related problems, compared to 9% after TKA NexGen® PS with patella resurfacing. There was no difference in cumulative incidence of revision after primary surgery of all TKA\'s using NexGen® PS with or without patella. To reduce the probability of reoperation for patella related problems, our data suggest the patella should be resurface during primary TKA.
摘要：
背景：在初次全膝关节置换术（TKA）中，髌骨表面置换仍存在争议。本研究的目的是调查单品牌原骨水泥TKA有或没有髌骨重铺后8年内翻修率和翻修原因是否存在差异。使用荷兰关节成形术注册的数据。
方法：所有采用后路稳定骨水泥原发NexGen®的原发TKA手术，对2010年至2013年诊断为骨关节炎的患者进行分析(n=5911).进行多因素cox回归分析，以分析有或没有髌骨成分的TKA之间的翻修率差异。并根据年龄和以前的手术进行了调整。
结果：5911TKA手术，4795例进行了髌骨置换（81.1％），1116例进行了髌骨置换（18.9％）。在初次TKA进行髌骨置换（9.3％）和未进行髌骨置换（29.9％）的患者之间，髌骨问题作为翻修原因存在显着差异（p=0.01）。这主要是由髌骨疼痛引起的(28.0%)。TKA合并髌骨重铺和不合并髌骨重铺之间的累积翻修率没有显着差异。
结论：结论：使用NexGen®PS的TKA后需要进行翻修手术的患者中有30％没有髌骨重铺的原因是与髌骨相关的问题，相比之下，采用TKANexGen®PS进行髌骨重铺后，这一比例为9%。使用NexGen®PS伴或不伴髌骨的所有TKA初次手术后翻修的累积发生率无差异。减少髌骨相关问题再次手术的概率，我们的数据表明,原发性TKA期间髌骨应重新出现.
方法：所有采用后路稳定骨水泥原发NexGen®的原发TKA手术，对2010年至2013年诊断为骨关节炎的患者进行分析(n=5911).进行多因素cox回归分析，以分析有或没有髌骨成分的TKA之间的翻修率差异。并根据年龄和以前的手术进行了调整。
结果：5911TKA手术，4795例进行了髌骨置换（81.1％），1116例进行了髌骨置换（18.9％）。在初次TKA进行髌骨置换（9.3％）和未进行髌骨置换（29.9％）的患者之间，髌骨问题作为翻修原因存在显着差异（p=0.01）。这主要是由髌骨疼痛引起的(28.0%)。TKA合并髌骨重铺和不合并髌骨重铺之间的累积翻修率没有显着差异。
结论：结论：使用NexGen®PS的TKA后需要进行翻修手术的患者中有30％没有髌骨重铺的原因是与髌骨相关的问题，相比之下，采用TKANexGen®PS进行髌骨重铺后，这一比例为9%。使用NexGen®PS伴或不伴髌骨的所有TKA初次手术后翻修的累积发生率无差异。减少髌骨相关问题再次手术的概率，我们的数据表明,原发性TKA期间髌骨应重新出现.
