| Abstract ID |
| 20260043 |
| Category |
| Knee: Osteotomy |
| Preferable Presentation |
| Oral Presentation |
| Title |
| INLAY VERSUS ONLAY PATELLA RESURFACING IN HAND-HELD ROBOTIC-ASSISTED TOTAL KNEE ARTHROPLASTY BASED ON KINEMATIC ANALYSIS |
| Author |
|
| Presenter |
| Dhananjaya sutanto |
| Abstract |
| example Background Patella resurfacing is part of surgical procedure in Total Knee Arthroplasty (TKA) for end-stage Knee Osteoarthritis (KOA) patients. Patella resurfacing technique can be divided into Inlay and Onlay patella resurfacing with different studies resulting in conflicting recommendation. These conflicting results could be due to continued advances in prosthetic designs resulting in higher patient favourability, difference in surgeon skill and surgical instrument availability, and the unique geometry of the knee requiring more precise kinematic measurement, especially during functional tasks such as weight-bearing knee flexion.the 1500s Objectives Assess the detailed kinematic and perceived functional difference of Inlay relative to Onlay patella resurfacing TKA recipients during weight-bearing knee flexion. study design 32 end-stage KOA patients were recruited, 24 received Inlay patella resurfacing while 8 that received Onlay patella resurfacing in their Bi-Cruciate Stabilized (BCS) TKA procedure. Fluoroscopic imaging was utilized to record knee kinematics as participants transitioned from full extension through progressive 30° flexion increments until terminal flexion was achieved under bodyweight-bearing conditions. Kinematic variables include maximum flexion angle, femorotibial axial rotation, medial and lateral condyle posterior rollback. Functional restoration was measured based on Knee Society Functional Score (KSFS) and Knee Society Score (KSS) outcome difference between pre-surgery and 12 months follow-up. Results There was no significant difference based on the kinematic outcomes. Maximum weight-bearing flexion was 105 ± 7.1° [90 to 116°] for Inlay cohort and 104 ± 23.0° [70 to 137°] for Onlay cohort. Lateral condylar rollback was -13.1 ± 4.6 mm [ -20.2 to -1.3 mm] for Inlay cohort and -12.6 ± 7.8 mm [-21.6 to -0.6 mm] for Onlay cohort. Medial condylar rollback was -5.7 ± 2.2 mm [-11.9 to +1.1 mm] for Inlay cohort and -6.1 ± 5.1 mm [-11.8 to +2.0 mm] for Onlay cohort. Femorotibial axial rotation was 9.2 ± 5.1° [-4.8 to +17.9°] for Inlay cohort and 7.9 ± 6.60 [-1.7 to +19.6°] for Onlay cohort. Both groups experienced significant functional improvement based on KSFS change of + 26 ± 18.5 [-10 to +55] for Inlay cohort and +27 ± 16.8 [-6 to + 40] for Onlay cohort. Both groups also significantly improved based on KSS change of +33 ± 18.8 [+5 to +73] for Inlay cohort and +35 ± 24.7 [-3 to +81] for Onlay cohort. Conclusions Both groups experience kinematic restoration and functional improvement following TKA regardless of the type of patella resurfacing type they received. Surgeons providing BCS TKA surgery to end-stage KOA patients should consider other factors such as the patient’s patella thickness, bone quality, and alignment when deciding if the patient should receive Inlay or Onlay patella resurfacing. |