The patella in total knee arthroplasty

Area of Science:

• Orthopedic surgery
• Biomaterials science

Background:

• The decision to resurface the patella during total knee arthroplasty remains controversial.
• Long-term outcomes of patellar cartilage interacting with femoral components are not fully established.

Purpose of the Study:

• To examine the ongoing debate regarding patellar resurfacing in total knee arthroplasty.
• To investigate the durability of patellar cartilage in contact with femoral components.
• To identify factors influencing complications associated with patellar resurfacing.

Main Methods:

• Review of existing literature on patellar resurfacing techniques and outcomes.
• Analysis of complications such as fracture, rupture, and instability.
• Discussion of component design implications, including metal-backed components.

Main Results:

• Technique-related complications like fracture, rupture, and instability can be reduced with careful surgical execution.
• Metal-backed designs are associated with component breakage.
• The etiology of patellar clunk syndrome is not yet fully elucidated.

Conclusions:

• While improved surgical technique can mitigate some risks, controversy regarding patellar resurfacing persists.
• Further research is needed to understand long-term cartilage wear and the causes of patellar clunk.
• Component design plays a role in the success and potential complications of total knee arthroplasty.