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The effect of infrapatellar fat pad resection on outcomes post-total knee arthroplasty: a systematic review

Journal Article


Abstract


  • Introduction

    The infrapatellar fat pad (IPFP) is resected in approximately 88 % of total knee arthroplasty (TKA) surgeries. The aim of this review is to investigate the impact of the IPFP resection on clinical outcomes post-TKA.

    Materials and methods

    A systematic search of five major databases for all relevant articles published until May, 2015 was conducted. Studies comparing the effect of IPFP resection and preservation on outcomes post-TKA were included. Each study was then assessed individually for level of evidence and risk of bias. Studies were then grouped into post-operative outcomes and given a level of evidence ranking based on the collective strength of evidence.

    Results

    The systematic review identified ten studies suitable for inclusion, with a total of 10,163 patients. Within these ten studies, six post-operative outcomes were identified; knee pain, vascularisation of the patella, range of motion (ROM), patella tendon length/patella infera, wound complications and patient satisfaction. Moderate evidence increased knee pain with IPFP resection post-TKA was found. Conflicting evidence was found for patella vascularisation and patellar tendon length post-TKA. Moderate evidence for no difference in ROM was found. One low quality study was found for wound complications and patient satisfaction.

    Conclusions

    This systematic review is limited by the lack of level one randomised controlled trials (RCTs). There is however moderate level evidence that IPFP resection increases post-operative knee pain. Further level one RCTs are required to produce evidence-based guidelines regarding IPFP resection.

UOW Authors


  •   White, Leigh D. (external author)
  •   Holyoak, Rhys S. (external author)
  •   Sant, J (external author)
  •   Hartnell, Nicholas J. (external author)
  •   Mullan, Judy

Publication Date


  • 2016

Citation


  • White, L., Holyoak, R., Sant, J., Hartnell, N. & Mullan, J. (2016). The effect of infrapatellar fat pad resection on outcomes post-total knee arthroplasty: a systematic review. Archives of Orthopaedic and Trauma Surgery, 136 (5), 701-708.

Scopus Eid


  • 2-s2.0-84961782020

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers/3752

Has Global Citation Frequency


Number Of Pages


  • 7

Start Page


  • 701

End Page


  • 708

Volume


  • 136

Issue


  • 5

Place Of Publication


  • Germany

Abstract


  • Introduction

    The infrapatellar fat pad (IPFP) is resected in approximately 88 % of total knee arthroplasty (TKA) surgeries. The aim of this review is to investigate the impact of the IPFP resection on clinical outcomes post-TKA.

    Materials and methods

    A systematic search of five major databases for all relevant articles published until May, 2015 was conducted. Studies comparing the effect of IPFP resection and preservation on outcomes post-TKA were included. Each study was then assessed individually for level of evidence and risk of bias. Studies were then grouped into post-operative outcomes and given a level of evidence ranking based on the collective strength of evidence.

    Results

    The systematic review identified ten studies suitable for inclusion, with a total of 10,163 patients. Within these ten studies, six post-operative outcomes were identified; knee pain, vascularisation of the patella, range of motion (ROM), patella tendon length/patella infera, wound complications and patient satisfaction. Moderate evidence increased knee pain with IPFP resection post-TKA was found. Conflicting evidence was found for patella vascularisation and patellar tendon length post-TKA. Moderate evidence for no difference in ROM was found. One low quality study was found for wound complications and patient satisfaction.

    Conclusions

    This systematic review is limited by the lack of level one randomised controlled trials (RCTs). There is however moderate level evidence that IPFP resection increases post-operative knee pain. Further level one RCTs are required to produce evidence-based guidelines regarding IPFP resection.

UOW Authors


  •   White, Leigh D. (external author)
  •   Holyoak, Rhys S. (external author)
  •   Sant, J (external author)
  •   Hartnell, Nicholas J. (external author)
  •   Mullan, Judy

Publication Date


  • 2016

Citation


  • White, L., Holyoak, R., Sant, J., Hartnell, N. & Mullan, J. (2016). The effect of infrapatellar fat pad resection on outcomes post-total knee arthroplasty: a systematic review. Archives of Orthopaedic and Trauma Surgery, 136 (5), 701-708.

Scopus Eid


  • 2-s2.0-84961782020

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers/3752

Has Global Citation Frequency


Number Of Pages


  • 7

Start Page


  • 701

End Page


  • 708

Volume


  • 136

Issue


  • 5

Place Of Publication


  • Germany