Should the patella be resurfaced at total knee replacement?

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Total knee replacement (TKR) aims to restore knee function but definitions of 'total' vary.
• The extent of articular surface replacement in TKR is not consistently applied.
• Patellar involvement in TKR is a subject of ongoing debate.

Purpose of the Study:

• To advocate for patellar resurfacing in the majority of total knee replacement (TKR) procedures.
• To critically justify the routine resurfacing of the patella during TKR.
• To examine the potential drawbacks and alternative surgical options to patellar resurfacing.

Main Methods:

• Literature review and critical analysis of existing TKR techniques.
• Evaluation of biomechanical and clinical outcomes of patellar resurfacing versus non-resurfacing.
• Discussion of surgical decision-making criteria for patellar management in TKR.

Main Results:

• The definition of 'total' knee replacement is often inconsistent regarding patellar resurfacing.
• Strong clinical rationale exists for routine patellar resurfacing in most TKR cases.
• Potential complications and alternative management strategies require careful consideration.

Conclusions:

• Patellar resurfacing should be strongly considered in most total knee replacement surgeries.
• A thorough understanding of the evidence is crucial for optimizing TKR outcomes.
• Further research should focus on patient selection and long-term efficacy of patellar management in TKR.