Total Knee Arthroplasty after Complete Patellectomy: A Review

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Regenerative Medicine

Background:

• Patellar absence or dysfunction accelerates knee osteoarthritis and complicates total knee arthroplasty (TKA).
• Current management strategies for TKAs following patellectomy include component modification, autograft, allograft, and prosthetic reconstruction.
• Optimal treatment for complete patellectomy during TKA remains undetermined.

Purpose of the Study:

• To review the basic biology and biomechanics of the patella and extensor mechanism.
• To synthesize current literature on managing complete patellectomy in TKA.
• To inform optimal treatment strategies for this complex patient group.

Main Methods:

• Literature review of studies on patellar biomechanics and TKA after patellectomy.
• Analysis of various reconstructive techniques and their reported outcomes.
• Exploration of tissue engineering principles relevant to extensor mechanism repair.

Main Results:

• Degenerative joint disease progression is linked to extensor mechanism compromise.
• Multiple surgical options exist, but evidence for a superior method is limited.
• Emerging tissue engineering approaches may offer future solutions.

Conclusions:

• Effective management of the extensor mechanism is crucial for TKA success.
• Further research is needed to establish evidence-based guidelines for patellectomy reconstruction.
• Tissue engineering holds promise for restoring extensor mechanism function.