Resurfacing Versus Non-resurfacing Patella in Total Knee Replacement: When and What to Choose

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Arthroplasty Research

Background:

• The necessity of patella resurfacing during total knee arthroplasty (TKA) remains a debated topic in orthopedic surgery.
• Existing approaches include routine resurfacing, no resurfacing, or selective resurfacing, with varied supporting evidence but no clear consensus.

Purpose of the Study:

• To compare functional and radiological outcomes of TKA with and without patella resurfacing.
• To identify the advantages and disadvantages of each surgical technique in TKA.

Main Methods:

• Retrospective study of 106 TKA cases over 5 years.
• Comparison between 29 resurfaced patellas and 77 non-resurfaced patellas.
• Analysis of functional results (e.g., Knee Society Score) and complication rates.

Main Results:

• No significant difference in patient satisfaction or Knee Society Score (KSS) between resurfaced and non-resurfaced groups.
• Resurfacing was associated with complications like infection, anterior pain, stiffness, loosening, increased costs, and operative time.
• Meta-analyses generally show no discernible clinical or functional benefit from patellar resurfacing in TKA.

Conclusions:

• Routine patella resurfacing in TKA is generally not necessary.
• Selective resurfacing is recommended for specific conditions like inflammatory arthropathy, significant malalignment, or severe osteoarthritis.
• The final decision on patella management should be based on surgeon expertise and patient-specific factors.