Affiliation:
1. Department of Orthopaedic Surgery, the First Affiliated Hospital Fujian Medical University Fuzhou China
2. Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital Fujian Medical University Fuzhou China
3. Fujian Provincial Institute of Orthopedics, the First Affiliated Hospital Fujian Medical University Fuzhou China
4. Fujian Orthopaedic Bone and Joint Disease and Sports Rehabilitation Clinical Medical Research Center Fuzhou China
5. Department of Stomatology, the First Affiliated Hospital Fujian Medical University Fuzhou China
6. Department of Stomatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital Fujian Medical University Fuzhou China
Abstract
ObjectiveThe management of the infrapatellar fat pad (IPFP) during total knee arthroplasty (TKA) remains controversial. This study aimed to evaluate a novel IPFP preservation technique—“the medially pedicled IPFP flap”—for reducing postoperative pain, wound complications, and improving functional recovery after TKA.MethodsA retrospective analysis was conducted on TKA cases at our institution from 2018 to 2021, including those with IPFP preservation (medially pedicled flap) versus IPFP complete resection. Patient demographics, perioperative parameters (blood loss, operative time, length of hospital stay, visual analogue scale [VAS] score, white cell count [WBC], C‐reactive protein [CRP], erythrocyte sedimentation rate [ESR], and wound oozing), and postoperative follow‐up data (VAS, Knee Society [KSS], or Knee Society functional assessment [KSFA] scores) were compared between groups. Independent sample t‐tests were used to compare continuous data and chi‐squared tests were used to compare categorical data between groups.ResultsSix hundred thirty patients were included, with 278 in the medial pedicled IPFP flap group (preservation group) and 352 in the IPFP resection group (resection group). The operative time was significantly shorter in the preservation versus resection group (125.5 ± 23.2 vs 130.3 ± 28.7 mins, p = 0.03), as was the length of hospital stay (8.4 ± 2.7 vs 9.2 ± 2.3 days, p < 0.01). Regarding pain, the preservation group had significantly lower VAS scores on postoperative day 2 (2.0 ± 0.8 vs 2.4 ± 1.2, p < 0.001) and day 3 (1.5 ± 0.5 vs 1.8 ± 1.0, p < 0.001). CRP and ESR levels on postoperative day 5 were also significantly lower in the preservation group. Wound oozing rates were significantly lower in the preservation versus resection group (0.7% vs 2.8%, p = 0.04). No significant differences existed in VAS, KSS, or KSFA scores at the last follow‐up.ConclusionThe novel IPFP preservation technique significantly improved surgical exposure, shortened operative time and length of hospital stay. It also reduced wound pain and oozing compared to IPFP resection.