CONSEQUENCES OF ANTERIORFEMORAL NOTCHING AFTER TOTAL KNEE ARTHROPLASTY

Abstract

BACKGROUND: Osteoarthritis of the knee, one of the most common causes of disability, continues to increase in prevalence as the older adult and obese populations grow. More than 50% of patients older than 65 years have radiographic changes in the knee that indicate arthritis. MATERIALS AND METHODS:  This is a prospective study of 250 Total knee replacements performed for Osteoarthritis of knee. Study done at Department of Orthopaedics, Smimer hospital, Surat from May 2022 to January 2023. follow up for patients were being followed on 15 days,6 weeks,3,6 and 12 months and degree of anterior notching was determined by postoperative radiographs. RESULTS:  250 patients enrolled in our study. Average age of the patients was 63 years. Total No. of TKAs were 249. In which 165 were female and 84 were male. Total number of patients that developed notching was 52 which is 21% of the patient’s undergoing surgery. In our study 38 patients developed grade 1 notching while 14 developed grade 2 notching. CONCLUSION: From the study it can be concluded that There is no significant increase in risk of supracondylar femur fracture due to anterior notching. [Yates’ corrected p value 0.88(>0.05)]. The duration of pain following notching initially reduces the range of motion immediate postoperatively, but on longer follow up range of motion was satisfactory in both the patients with notching as well as in the ones without notching. However longer follow up is necessary. Anterior notching is more common in females probably due to small sized distal femur in indian population. There is no difference in clinical outcomes between notching and without notching patients. Both groups have same range of motion, no or minimal pain, can sit with cross legs and can squat.

KEY WORDS: Anterior femoral notching, Total knee replacement.