The Influence of Infrapatellar Fat Pad Resection on Outcomes Following Total Knee Arthroplasty
Bibliographic record
Abstract
Introduction: During a total knee arthroplasty, resection of the infrapatellar fat pad is usually performed to widen the surgical exposure.However, infrapatellar fat pad resection is known to produce shortening of the patellar tendon which leads to poor clinical outcomes following a total knee arthroplasty.Otherwise, recent studies suggested that the infrapatellar fat pad secretes proinflammatory cytokines.Thus, preservation of the infrapatellar fat pad may cause anterior knee pain after a knee replacement surgery.The purpose of the present study is to compare the patellar tendon length and clinical outcomes in the knees receiving either fat pad resection or fat pad retention during a total knee arthroplasty.Methods: One hundred and twenty patients (mean age, 70.2 years), undergoing sequential simultaneous bilateral total knee arthroplasty for latestage osteoarthritis, were randomized to have infrapatellar fat pad resected in one knee and preserved in the contralateral knee.Seven patients were men, and 113 were women.At the mean of 2.4 years postoperatively, patients were evaluated, clinically, with the knee-rating systems of the Knee Society and the Hospital for Special Surgery and with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score.In addition, patellar tendon length and component position were measured, radiographically, and were compared between the two groups.Results: At 3 months, 12 months, or 24 months after the surgery, there were no significant differences between the fat pad resection and retention group in terms of the knee-scoring systems, range of motion, anterior knee pain and patient preference.With regard to the patellar tendon length, tibio-femoral anlge, femoral component position, tibial component position, joint line level and patellar tilt, no significant differences were found between the two groups at any follow-up interval.However, lateral overhang or underhang of the tibial component of more than 3 mm was observed in seven knees in the retention group, as compared with one knee in the resection group.Conclusions: After a minimum duration of follow-up of two years, no significant differences were identified between the fat pad resection and retention groups, with respect to the clinical outcomes and patellar tendon length.However, the incidence of size mismatch between the lateral aspect of the tibial component and the lateral surface of the proximal tibia was observed more often in the fat pad retention groups.Therefore, routine resection of the infrapatellar fat pad for enhanced surgical exposure was recommended during a total knee arthroplasty.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".