Prevalence of patella baja in primary total knee arthroplasty

Objectives: Total knee arthroplasty (TKA) is a successful surgical intervention; however, abnormal patellar height, particularly patella baja (PB), can lead to complications and inferior outcomes. This study aimed to determine the prevalence of PB in patients undergoing primary TKA at a single tertiary care center in Saudi Arabia, hypothesizing that the incidence would be higher than that reported in the literature. Methods: This study employed a cross-sectional design. We reviewed the records of 106 patients who underwent primary TKA over a 1-year period. Pre-operative lateral knee radiographs were assessed using the Insall–Salvati ratio (ISR) and Blackburne–Peel ratio (BPR) to identify PB. Patients with inflammatory arthritis, major knee trauma, or a history of knee surgery were excluded from the study. No exclusions were made based on body mass index. Results: Among the 106 knees analyzed, 13.21% were diagnosed with PB based on ISR, and 65.09% were classified as PB using BPR. The majority of the cohort consisted of female patients (80.19%), with an average age of 64.91 years. Conclusion: The incidence of PB in our study population was significantly higher than previously reported rates, highlighting the importance of orthopedic surgeons remaining vigilant regarding this anatomical variation during TKA. Tailored surgical techniques are essential for mitigating the potential complications associated with PB.