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Abstract
Background — Attempts to relate patellar cartilage involvement to anterior knee pain (AKP) have yielded conflicting results. We determined whether the condition of the cartilage of the patella at the time of knee replacement, as assessed by the OARSI score, correlates with postsurgical AKP.
Patients and methods — We prospectively studied 100 patients undergoing knee arthroplasty. At surgery, we photographed and biopsied the articular surface of the patella, leaving the patella unresurfaced. Following determination of the microscopic grade of the patellar cartilage lesion and the stage by analyzing the intraoperative photographs, we calculated the OARSI score. We interviewed the patients 1 year after knee arthroplasty using the HSS patella score for diagnosis of AKP.
Results — 57 of 95 patients examined had AKP. The average OARSI score of painless patients was 13 (6–20) and that of patients with AKP was 15 (6–20) (p = 0.04). Patients with OARSI scores of 13–24 had 50% higher risk of AKP (prevalence ratio = 1.5, 95% CI: 1.0–2.3) than patients with OARSI scores of 0–12.
Interpretation — The depth and extent of the cartilage lesion of the knee-cap should be considered when deciding between the various options for treatment of the patella during knee replacement.
VM designed the study, performed the arthroplasties, collected data, and wrote the first draft of the manuscript. SV supervised the data collection and planned and performed the data analysis. KL supervised the work of the histology technicians in the pathology lab and microscopically examined the histological sections of the biopsies of the patella. AM designed the study and assisted in interpreting the results. All the authors contributed to revision of the manuscript and approved the final version.
The study was supported by the East-Tallinn Central Hospital and the Seventh EU RTD Framework Program (project no. 602398 HypOrth.).
No competing interests declared.