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Total knee replacement and patellofemoral pain
J E Arbuthnot1, M J McNicholas, D W McGurty
1Department of Orthopaedics and Trauma, Warwick Hospital, Lakin Road, Warwick. jamie@arbuthnot.me.uk
Summary
Patellar resurfacing during total knee replacement (TKR) did not significantly impact post-operative patellofemoral pain. The decision to resurface the patella for knee arthritis remains unclear, considering costs and complications.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- The decision to resurface the patella during total knee replacement (TKR) is a subject of ongoing debate among surgeons.
- Practices range from routine resurfacing to selective or never-resurfacing policies.
Purpose of the Study:
- To investigate the relationship between patellofemoral knee pain and total knee replacement outcomes.
- To evaluate the effect of patellar resurfacing on patellofemoral pain after TKR.
Main Methods:
- A prospective, non-randomized, multi-center outcome study involving 638 primary Insall Burstein II total knee replacements.
- Comparison of outcomes for 236 knees that underwent patellar resurfacing versus 142 knees that did not, among patients with pre-operative patellofemoral pain.
Main Results:
- No statistically significant difference in the incidence of post-operative patellofemoral pain was observed between knees with and without patellar resurfacing.
- In cases where patellofemoral pain developed after TKR, there was no significant difference based on whether the patella was resurfaced.
Conclusions:
- The clinical benefit of patellar resurfacing for managing patellofemoral pain in knee arthritis is not clearly established.
- Consideration of the costs and potential complications associated with patellar resurfacing is warranted.