Controversy: supporting patellar resurfacing in total knee arthroplasty - do it

Area of Science:

• Orthopedic surgery
• Biomechanics
• Arthroplasty

Background:

• Patellar resurfacing during total knee arthroplasty (TKA) is a controversial surgical decision.
• Surgeons vary in their approach: routine resurfacing, selective resurfacing based on specific criteria, or never resurfacing.

Purpose of the Study:

• To analyze current trends and controversial topics regarding patellar management in TKA.
• To review literature supporting the decision for routine patellar resurfacing.

Main Methods:

• Review of current literature on patellar resurfacing in TKA.
• Analysis of institutional experience and outcomes with routine patellar resurfacing since 2008.

Main Results:

• Selective resurfacing is based on preoperative pain, cartilage damage, arthritis type, and patellar instability.
• Routine patellar resurfacing at the institution has shown good outcomes and a low complication rate.
• Accurate component implantation is critical for successful patellar resurfacing.

Conclusions:

• Routine patellar resurfacing in TKA can lead to favorable outcomes with a low complication rate.
• A reproducible surgical technique is essential for minimizing postoperative anterior knee pain and implant-related complications.
• The decision to resurface the patella should consider joint anatomy, biomechanics, and surgical advancements.