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Patellectomy after total knee arthroplasty.

Michael A Chang1, James A Rand, Robert T Trousdale

  • 1Mayo Clinic, Rochester, MN 55905, USA.

Clinical Orthopaedics and Related Research
|October 22, 2005
PubMed
Summary
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Patellectomy after total knee arthroplasty (TKA) for patellar fractures may relieve pain but often results in poor function. Mild extensor lags are common, impacting stair use and overall knee function post-surgery.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Comminuted patellar fractures following total knee arthroplasty (TKA) can necessitate further surgical intervention.
  • Patellectomy is a potential, though debated, treatment option for such complications.

Purpose of the Study:

  • To evaluate the midterm outcomes of patellectomy performed after condylar TKA in patients with patellar fractures.
  • To assess the impact of patellectomy on pain, function, range of motion, and complications.

Main Methods:

  • Retrospective review of nine patients who underwent patellectomy after condylar TKA between 1969 and 2003.
  • Analysis of patient-reported pain and function scores, range of motion, and complication rates.
  • Follow-up of eight patients for an average of 49 months post-patellectomy.

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Main Results:

  • Knee pain scores post-patellectomy were comparable to those after initial TKA (81 vs. 83 points).
  • Functional knee scores significantly decreased after patellectomy (28 vs. 49 points).
  • Mild extensor lags (<10 degrees) were observed in 50% of patients, with two unable to use stairs. Complications included quadriceps tendon rupture and secondary instability.

Conclusions:

  • Patellectomy can offer pain relief for patellar fractures post-TKA.
  • However, functional outcomes following patellectomy are frequently compromised, with a notable incidence of extensor lags and functional limitations.
  • The procedure should be considered carefully due to potential functional deficits.