Patellar Morphology in Primary Total Knee Arthroplasty Patients with Unexplained Pain

Mohammed Ahmed Abdelkhalek Abdelrazek, Assistant Lecturer of Orthopedic Surgery, Mansoura University.Follow
Adham Elsharkawey Elgeidi, Professor of Orthopedic Surgery, Mansoura University.
Yasser Youssef Abdelrahman Abed, Assistant Professor of Orthopedic Surgery, Mansoura University.
Kamel Mohamed Ahmed Ahmed Youssef, Lecturer of Orthopedic Surgery, Mansoura University

Subject Area

Orthopaedic Surgery

Article Type

Original Study

Abstract

Background: An effective surgical procedure for treating end-stage osteoarthritis of the knee (OA) is total knee arthroplasty (TKA). Pain is the main reason why many patients are still unhappy with their results following TKA. Patients who did TKA may experience anterior knee pain (AKP) with or without patellar resurfacing. Research has indicated that the morphology of the patella or trochlear geometry affects the stress on the patellofemoral joint.

Objective: To determine whether clinical scores and pain after TKA without patellar resurfacing were correlated with patellar shape. Methods: This retrospective case control study included 70 cases. We retrospectively assessed patients with unexplained pain after primary TKA without patellar resurfacing at Knee surgery, Sports medicine, and Arthroscopy unit, Mansoura University Hospitals from January 2014 to December 2021. They were divided into painless group (34 cases) and unexplained painful group (36 cases). Clinical examination and clinical scores (VAS, WOMAC, FJS-12) were done to assess the pain. Laboratory investigations (CBC, CRP, and ESR) and radiological investigation including x-ray (weightbearing AP, lateral, and axial views) and CT rotational profile to exclude main causes of AKP.

Results: Wiberg class C showed statistically significant difference between studied groups. Among painful TKA, 22.2% (8 cases) have Wiberg class C versus none of painless group (P=0.012). Also, Wiberg class C showed higher mean WOMAC score in painful group (P=0.046). There were no significant differences between Wiberg type A and B regarding clinical and functional outcome in painless group.

Conclusion: Wiberg classification of the patella significantly affects clinical outcomes. Patients with Wiberg Class C patella exhibited higher levels of pain compared to those with Class A and B patella.

Recommended Citation

Abdelrazek, Mohammed Ahmed Abdelkhalek; Elgeidi, Adham Elsharkawey; Abdelrahman Abed, Yasser Youssef; and Ahmed Youssef, Kamel Mohamed Ahmed (2026) "Patellar Morphology in Primary Total Knee Arthroplasty Patients with Unexplained Pain," Mansoura Medical Journal: Vol. 55 : Iss. 4 , Article 10.
Available at: https://doi.org/10.58775/2735-3990.1556