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Related Experiment Videos

Patella resurfacing in total knee replacement: functional evaluation and complications.

P Aglietti1, A Baldini, R Buzzi

  • 1First Orthopedic Clinic of the University of Florence, Largo P. Palagi 1, 50139, Florence, Italy. ortosec@unifi.it

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|May 17, 2001
PubMed
Summary

Different knee replacement designs were evaluated for patellar function. The Meniscal Bearing Knee (MBK) showed improved patellar function with fewer impingements compared to Insall-Burstein (IB) designs.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Patellar complications and function are critical in total knee arthroplasty (TKA).
  • Trochlear design variations can influence patellofemoral mechanics and outcomes.

Purpose of the Study:

  • To prospectively evaluate three different knee replacement trochlear designs for clinical and radiographic patellar function.
  • To assess the incidence of patellar complications associated with each design.

Main Methods:

  • Clinical and radiographic evaluation of three knee replacement designs: Insall-Burstein I (IB-I), Insall-Burstein II (IB-II), and Meniscal Bearing Knee (MBK).
  • All patients received an all-polyethylene dome patellar prosthesis.
  • Exclusion of knees with pre-existing tibiofemoral issues.

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Main Results:

  • Early IB-I design had high impingement rates ('clunks'), reduced to 5% after smoothing the anterior edge.
  • IB-II design showed improved degree of clunks (4.5%) due to deeper trochlea for soft tissue clearance.
  • MBK design demonstrated very rare clunks and improved patellar function.
  • Patellar stress fractures and instability were infrequent across all designs; loosening or wear was not evident.
  • Over 80% of patients achieved normal function (including stairs).
  • Patella baja was the only radiological parameter correlated with symptoms in IB prostheses.

Conclusions:

  • Trochlear design significantly impacts patellofemoral mechanics and patient outcomes in knee arthroplasty.
  • The Meniscal Bearing Knee (MBK) design offers superior patellar function and reduced impingement.
  • Dome patellar prostheses are preferred for their tolerance and potential for conforming to the trochlear groove.