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Published on: May 5, 2023
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[Unilateral patellar resurfacing in bilateral total knee arthroplasty: a randomized controlled study]
1Arthritis Clinical and Research Center, Peking University People's Hospital, Beijing 100044, China; Department of Orthopedics, Peking University International Hospital, Beijing 102206, China.
Summary
For total knee arthroplasty (TKA) in patients with mild to moderate knee osteoarthritis (OA), retaining the patella yields similar outcomes to patellar resurfacing. This suggests patellar retention is a viable option, potentially simplifying the procedure.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Clinical Research
Background:
- Total knee arthroplasty (TKA) is a common procedure for knee osteoarthritis (OA).
- The management of the patella during TKA, whether through resurfacing or retention, remains a subject of clinical debate.
- Understanding the comparative outcomes is crucial for optimizing surgical techniques and patient results.
Purpose of the Study:
- To compare the clinical effects of patellar retention versus patellar resurfacing in patients undergoing bilateral total knee arthroplasty (TKA).
- To evaluate functional outcomes, pain levels, and patellar tracking after TKA with different patellar management strategies.
Main Methods:
- A randomized study involving 14 patients (28 knees) with bilateral knee OA undergoing TKA.
- Patients received unilateral patellar resurfacing and contralateral patellar retention.
- Clinical outcomes were assessed using the American Knee Society score (KSS), range of motion (ROM), anterior knee pain, patellar clunk, and patellar tilt angle (PTA) over a 3-12 month follow-up period.
Main Results:
- No statistically significant differences were observed between patellar resurfacing and retention groups in terms of KSS improvement (P=0.98), knee ROM (P=0.70), anterior knee pain (P=0.62), patellar clunk (P=1.00), or patellar tilt angle (P=0.36).
- All wounds healed primarily without major complications.
- Functional outcomes and patellar tracking were comparable between the two surgical approaches.
Conclusions:
- Patellar resurfacing or retention does not significantly impact anterior knee pain, patellar clunk, functional outcomes, or patellar tracking in TKA for patients with mild to moderate patellar cartilage damage.
- The findings support patellar retention as a suitable option in TKA for this patient population.
- This suggests that retaining the patella may be a preferred approach, potentially simplifying the surgical procedure.
