Total Infrapatellar Fat Pad Excision Leads to Worse Isokinetic Performance in Total Knee Arthroplasty: A Randomized Controlled Trial
Date
2022Author
Cankaya,DenizAktı,sefa
Yasar, Niyazi Erdem
Karakus,Dilek
Unal, Kazım Onur
Karhan, Taha Esref
Sezgin, Erdem Aras
Metadata
Show full item recordAbstract
There are concerns that total infrapatellar fat pad (IPFP) excision in total knee
arthroplasty (TKA) results in patellar tendon shortening due to ischemic contracture,
but individual preference of the surgeon is still the main determinant between total or
partial excision. The aim of this randomized controlled study was to compare isokinetic
performance and clinical outcome of TKAs with total and partial excision of the IPFP.
Seventy-two patients scheduled to undergo TKA for primary knee osteoarthritis by a
single surgeon were randomly assigned to either total or partial excision group.
Patients were evaluated preoperatively and at postoperative 1 year, with Knee Society
Score (KSS) and isokinetic measurements. The physiatrist performing isokinetic tests
and patients were blinded to the study. There were no significant differences between
the groups in respect of age, body mass index, gender, and preoperative KSS and
isokinetic performance. Postoperatively, both groups had improved KSS knee and KSS
function scores, with no difference determined. Knee extension peak torque was
significantly higher postoperatively in the partial excision group at postoperative 1 year
(p ¼ 0.036). However, there were no significant differences in knee flexion peak torque
following TKA (p ¼ 0.649). The results of this study demonstrated that total excision of
the IPFP during TKA is associated with worse isokinetic performance, which is most
likely due to changes in the knee biomechanics with the development of patella baja.
Partial excision of the IPFP appears to be a valid alternative to overcome this potential
detrimental effect without impeding exposure to the lateral compartment. This is a
Level I, therapeutic study