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Patellar resurfacing in total knee arthroplasty: a prospective, randomized trial
David J Wood1, Anne J Smith, Dermot Collopy
1Division of Orthopaedics, Department of Surgery, University of Western Australia, Nedlands, Western Australia, Australia.
The Journal of Bone and Joint Surgery. American Volume
|February 28, 2002
Summary
Patellar resurfacing in total knee arthroplasty reduces anterior knee pain and improves stair descent compared to patellar retention. However, anterior knee pain can still occur post-surgery, regardless of the procedure.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Clinical Outcomes Research
Background:
- Patellar management remains a challenge in total knee arthroplasty (TKA).
- This study investigates the clinical outcomes of TKA with or without patellar resurfacing.
Purpose of the Study:
- To compare the clinical outcomes of total knee arthroplasty based on the inclusion or exclusion of patellar resurfacing.
- To evaluate differences in anterior knee pain and functional outcomes.
Main Methods:
- A prospective, randomized, double-blind study involving 220 osteoarthritic knees undergoing TKA.
- Patients were assigned to either patellar resurfacing or patellar retention groups.
- Outcomes were assessed annually for a mean of 48 months using standardized clinical and radiographic evaluations.
Main Results:
- No significant difference in revision rates for patellofemoral complications between the two groups (12% vs. 10%).
- A significantly higher incidence of anterior knee pain was observed in the group without patellar resurfacing (p=0.016).
- Patellar resurfacing demonstrated superior clinical results regarding anterior knee pain and stair descent.
Conclusions:
- Patellar resurfacing in TKA leads to better clinical outcomes, particularly for anterior knee pain and stair descent.
- Anterior knee pain can persist even after patellar resurfacing, with 10% requiring reoperation.
- Joint loading, rather than obesity, may be a key factor in developing anterior knee pain in patients without patellar resurfacing.