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Patellar resurfacing in total knee arthroplasty. A prospective, randomized study.
1Institute of Orthopaedics, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom. mail@timwaters.com
The Journal of Bone and Joint Surgery. American Volume
|February 7, 2003
Summary
Patellar resurfacing during total knee arthroplasty significantly reduces anterior knee pain. This study recommends resurfacing the patella when possible to improve patient outcomes and satisfaction.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Clinical Trials
Background:
- Anterior knee pain is a frequent complication after total knee arthroplasty (TKA).
- Pain is often attributed to the patellofemoral joint.
- Indications for patellar resurfacing in TKA require clarification.
Purpose of the Study:
- To compare outcomes of patellar resurfacing versus non-resurfacing in TKA.
- To specifically evaluate the impact on anterior knee pain.
- To define optimal indications for patellar resurfacing during TKA.
Main Methods:
- Prospective, randomized study of 514 primary press-fit condylar TKAs.
- Patients randomized to patellar resurfacing or retention.
- Follow-up averaged 5.3 years, assessed using Knee Society rating, anterior knee pain score, and patient satisfaction.
Main Results:
- Anterior knee pain prevalence: 25.1% (non-resurfacing) vs. 5.3% (resurfacing) (p < 0.0001).
- Lower overall postoperative knee scores in the non-resurfacing group, especially for osteoarthritis patients (p < 0.01).
- Patients with bilateral replacements preferred the resurfaced side.
Conclusions:
- Patellar resurfacing significantly decreases anterior knee pain post-TKA.
- Recommendation for routine patellar resurfacing when technically feasible.
- Improved patient satisfaction and knee scores associated with patellar resurfacing.