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Nonresurfaced patella in total knee arthroplasty
S R Smith1, P Stuart, I M Pinder
1Freeman Hospital, Newcastle Upon Tyne, England.
The Journal of Arthroplasty
|January 1, 1989
Summary
Nonresurfaced patella in total knee arthroplasty can lead to patellofemoral complications, primarily due to malalignment. Careful surgical techniques are recommended to ensure accurate patellofemoral tracking and reduce anterior knee pain.
Area of Science:
- Orthopedics
- Biomedical Engineering
- Knee Arthroplasty
Background:
- Patellofemoral joint problems are a significant cause of disability after knee replacement.
- Patellar resurfacing in total knee arthroplasty (TKA) can cause complications like loosening, wear, and malalignment.
Purpose of the Study:
- To review experiences with nonresurfaced patella in TKA.
- To identify causes of patellofemoral complications and recommend surgical strategies.
Main Methods:
- Two studies analyzed outcomes of nonresurfaced patella in TKA.
- Postoperative skyline views assessed patellar tracking.
- Long-term durability and bone remodeling were evaluated.
Main Results:
- Patellofemoral symptoms occurred in 8% of patients, mainly due to malalignment.
- Dynamic patellar maltracking was identified as a cause of anterior knee pain.
- Nonresurfaced patella showed stable tracking over time with bone remodeling in 85%.
Conclusions:
- Accurate patellofemoral tracking is crucial during TKA.
- Staged surgical procedures, including osteophyte removal and iliotibial tract release, are recommended for neutral tracking.
- The nonresurfaced patella is supported, but malalignment remains a key disability source.