Excisional arthroplasty for patellar loosening in total knee arthroplasty

Four thousand two hundred eighty-seven cases of Anatomic Graduated Components total knee replacements with a cemented, single-peg, all-polyethylene patellar component were performed at our institution over the past 15 years. One hundred eighty cases of patellar component loosening were found. Eleven knees (0.3%) in 11 patients required isolated patellar component reoperation. In all cases, the patellar component was excised and not reimplanted. The average follow-up for the 11 patients was 2.2 years. Five had a complete minimum follow-up of 2 years following reoperation. Pain and function were improved. Complications included infection in 3 knees and extensor lag in 1 knee. Because of the complication rate associated with isolated patellar component excision caused by a loose patellar component, we recommend surgical removal of the patellar component only in cases of severe pain and/or prominence of the component.