Resumen de Influencia de la pseudopatela baja sobre la artroplastia de rodilla
Introducción: La evidencia disponible sobre la pseudopatela baja (PPB) es limitada. El propósito de este estudio era investigar prospectivamente la aparición de PPB después de la artroplastia total de rodilla (ATR) primaria y sus consecuencias clínicas en una serie de pacientes con un seguimiento mínimo de 2 años. La PPB se definió como una rótula distalmente desplazada en relación con la tróclea femoral con ausencia de acortamiento del tendón rotuliano debido a la elevación de la línea articular.
Desarrollo teórico: Métodos: Serie prospectiva de 354 pacientes con una edad media de 71,7 (rango, 52-87) años. La evaluación clínica fue realizada por la Knee Society Scores (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short-Form 12-item (SF12) y rango de movimiento (ROM). La altura de la rótula se evaluó mediante los índices de Insall-Salvati (ISR) y Blackburne-Peel (BPR).
Resultados: El seguimiento medio fue de 3,6 (rango, 2,0-6,6) años. En el posoperatorio, 286 (80,7%) pacientes tenían una altura patelar normal, 17 (4,8%) una verdadera patela baja (VPB) y 51 (14,4%) una PPB. No hubo diferencias significativas entre los 3 grupos en la escala KSS-función media (p= 0,107), ROM (p= 0,408), WOMAC-dolor (p= 0,095), WOMAC-rigidez (p= 0,279) o SF12-mental (p= 0,363). Entre los grupos normales y PPB, no hubo diferencias significativas en la media de KSS-rodilla (p= 0,903), WOMAC-función (p= 0,294) o SF12-físico (p= 0,940). Sin embargo, el grupo TPB tuvo una media de KSS-rodilla (p= 0,031), WOMAC-función (p= 0,018) y SF12-física (p= 0,005) significativamente peores en comparación con los otros 2 grupos.
Conclusión: La PPB fue un hallazgo relativamente común, pero no se encontraron diferencias significativas en términos de resultados clínicos en comparación con los pacientes con altura rotuliana posoperatoria normal La VPB fue poco frecuente, pero estos pacientes tuvieron resultados clínicos significativamente peores que aquellos con PPB o altura patelar normal.
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