ISSN: 1546-962X
CODEN: JAIOAD
Published Online: 16 August 2011
Page Count: 6

The Incidence of Anterior Knee Pain and Crepitation After Total Knee Replacement: A Matched Pair Analysis between Rotating Platform and Fixed Bearing Posterior Stabilized Designs

Ranawat, Amar S.
Assistant Professor of Orthopaedic Surgery, Weill Medical College of Cornell Univ., Hospital for Special Surgery,

Meftah, Morteza
Adult Reconstruction Research Fellow, Weill Medical College of Cornell Univ., Hospital for Special Surgery,

Rodriguez-Elizalde, Sebastian
Adult Reconstruction Fellow, Weill Medical College of Cornell Univ., Hospital for Special Surgery,

Ranawat, Chitranjan S.
Weill Medical College of Cornell University, Hospital for Special Surgery,

(Received 20 December 2010; accepted 19 July 2011)

Abstract

Persistent pain, especially anterior knee pain, with or without crepitation, has been a persistent complaint after total knee arthroplasty in both rotating platform posterior stabilized (RP-PS) and fixed bearing posterior stabilized (FB-PS) designs. Because PFC Sigma RP-PS and FB-PS designs have identical femoral components, we hypothesized that the incidence of post-operative pain, anterior knee pain, asymptomatic crepitation, painful crepitation, and painful crepitation requiring scar excision is similar in both designs. Between March 2000 and May 2004, 81 near-consecutive RP-PS Total Knee Replacements (TKRs) were matched to 81 FB-PS knees based on gender, age, and body mass index. Radiographic analysis included alignment, fixation, and patellar tilt. Clinical assessments were performed at the time of follow-up using the Knee Society Scores. The incidence of anterior knee pain and crepitation was investigated using a detailed patient administered questionnaire. The incidence of post-operative pain, anterior knee pain, asymptomatic crepitation, and painful crepitation was similar in both groups (20.9 %, 19.7 %, 1.2 %, and 8.6 % in the RP-PS; and 20.9 %, 18.5 %, 0 %, and 6.1 % in the FB-PS, respectively). The severity of painful crepitation was also similar in both groups. None was excruciating. The incidence of painful crepitation requiring scar excision was slightly higher in the RP-PS group (6.1 % versus 2.4 %) but it was not statistically significant. In conclusion, there is a trend of increased incidence of painful crepitation requiring scar excision in the RP-PS TKR, although it was not statistically significant in this study.

Keywords:
anterior knee pain, crepitation, total knee replacement, rotating platform, fixed bearing, posterior stabilized

Paper ID: JAI103725
DOI: 10.1520/JAI103725
ASTM International is a member of CrossRef.