Patellar resurfacing for patellofemoral arthritis

Area of Science:

• Orthopedics
• Biomedical Engineering

Background:

• Patellofemoral pain is a frequent orthopedic issue.
• Non-operative treatments (activity modification, NSAIDs, isometric strengthening) are often effective.
• Surgical options for refractory pain lack consistent durability and reproducibility.

Purpose of the Study:

• To evaluate the efficacy of surgical interventions for patellofemoral knee pain.
• To compare outcomes of isolated patellar/patellofemoral resurfacing with total knee replacement.
• To provide recommendations for surgical management of patellofemoral arthritis.

Main Methods:

• Review of surgical outcomes for isolated patellar resurfacing.
• Analysis of patellofemoral resurfacing procedures.
• Assessment of total knee replacement (TKR) in patients with primary patellofemoral arthritis.
• Evaluation of patellar resurfacing as part of TKR.

Main Results:

• Isolated patellar resurfacing may benefit younger patients with severe anterior knee pain but carries a high risk of future surgery.
• Patellofemoral resurfacing has broader knee joint involvement, potentially limiting salvage options like patellectomy.
• Total knee replacement shows superior durability and predictability compared to isolated resurfacing procedures, even in knees with primary patellofemoral arthritis.

Conclusions:

• Total knee replacement is the most reliable treatment for severe patellofemoral arthritis.
• Isolated resurfacing procedures have guarded outcomes and may necessitate further interventions.
• Resurfacing all patellae during TKR is recommended, with attention to component type and surgical technique to minimize complications.