The Effect Of Patella Stability After Total Knee Arthroplasty Using Sutured Medial Joint Capsule By Non-Absorbable Sutures

ObjectiveTo analyze the effect of the use of non-absorbable suture to strengthen the medial joint capsule on the stability of the patella after primary total knee arthroplasty.To compare the relationship between different suture methods and the stability of the patella after total knee arthroplasty.Postoperative patellar instability to choose a more optimized suture provides clinical basis.MethodsThis study retrospectively analyzed the data of 37 consecutive patients who underwent primary total knee arthroplasty for end-stage knee osteoarthritis from December 2014 to September 2017.The data were analyzed retrospectively according to whether intraoperative use of non-absorbable suture to strengthen the sutured medial joint.The patients were divided into group A,group B and group C.The knee knee ankle angle(HKA),insall-Salviti index(ISR),patella tilt angle were measured by the total length of the lower extremity,the knee joint and the patellar 30 ° axial radiographs before and after operation.Patella tilt angle(PTA)and congruence angle(CA)were used.Knee activity score(KSS)scores of all the patients were included in the score.Comparing the data of three groups of patients,including HKA,ISR,PTA,CA and KSS scores in the X-ray before and after the surgery were followed up for1 month and 6 months after operation.ResultsA total of 37 patients were enrolled in this retrospective study.The group A consisted of 14 patients,with a mean age of 66.62±8.19 years and a mean follow-up time of 13±9.36 months.Ten patients in the group B had an average age of 69.30±6.65 years and an average follow-up period of 9.3±5.01 months.Thirteen patients with group C were included.The average age was 67.07±6.51 years and the average follow-up time was 7.71±3.02 months.No postoperative complications of TKA occurred during follow-up of all patients.The KSS clinical score,KSS functional score,ROM,and HKA were significantly improved in the group A(P<0.05).ROM was improved more significantly at the final follow-up postoperatively.However,ISR,PTA,and CA had no significant difference between before and after surgery(P>0.05).In group B,the KSS clinical score,KSS functional score,and ROM were not significantly improved at 1 month postoperatively(P>0.05),but were significantly improved at the final follow-up postoperatively(P< 0.05).PTA was significantly reduced after surgery(P<0.05).HKA,ISR,and CA,there was no significant difference between before and after surgery(P>0.05).In group C,KSS clinical scores,KSS functional scores,and HKA were significantly improved after surgery(P<0.05).There was no significant difference in ROM at the 1-month follow-up(P>0.05),but it was significantly higher at the final follow-up(P<0.05),Compared with preoperative ROM.CA was significantly decreased after surgery(P<0.05).Both of ISR and PTA,there was no significant difference between before and after surgery(P>0.05).ConclusionIn TKAs using medial patellar approach,the use of non-absorbable sutures to strengthen the the medial joint capsule can reduce postoperative patella tilt and enhance the stability of the patella.Non-absorbable sutures are used to strengthen the medial joint capsule after patella resurfacing which can improve patello-femoral joint matching,and enhance the stability of the patella.