Is Inflammatory Arthritis an Absolute Indication for Patellar Resurfacing in Total Knee Arthroplasty?
Bryant M Song1, Caleb A Ford1, Andrew M Schneider1
1Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri.
Background:
Inflammatory arthritis (IA) has been considered an absolute indication for patellar resurfacing (PR) in total knee arthroplasty (TKA), yet limited data supports this. The purpose of this study was (1) to compare outcomes of TKA without PR for IA and osteoarthritis (OA) and (2) to compare outcomes of TKA for IA with and without PR.
Methods:
A retrospective review of primary TKAs between March 2017 to May 2024 was performed. We identified 348 TKAs without PR performed for IA. This cohort was matched by demographics to 348 TKAs without PR performed for OA. A secondary comparison of 38 TKAs for IA with PR (IA-PR) was performed. Outcomes included reoperation, revision, patella-related complications, and presence of anterior knee pain (AKP). The mean follow-up was 24 months. T-tests and Fisher exact tests were performed.
Results:
Among TKA without PR, 20 (5.7%) IA and 13 (3.7%) OA underwent reoperation (P = 0.28); two (0.6%) in each group underwent revision (P = 1.0). There were no differences in aseptic (3.4 IA versus 2.6% OA; P = 0.66), patella-related (1.4 IA versus 0.9% OA; P = 0.73), or septic (2.3 IA versus 1.1% OA; P = 0.38) reoperations. Among TKA without PR, there was no difference in AKP between IA (4.9%) and OA (7.8%) (P = 0.16). Among TKA for IA with and without PR, there was no difference in AKP (4.9 IA versus 5.3% IA-PR; P = 0.58). The PR group had more aseptic reoperations (3.4 IA versus 13.2% IA-PR; P = 0.02) and revisions (0.6 IA versus 13.2% IA-PR; P < 0.01), but similar patella-related complications (1.4 IA versus 2.6% IA-PR; P = 0.47).
Conclusions:
In TKA without PR for IA compared to OA, there were no differences in reoperations, revisions, patella-related complications, or AKP. Additionally, PR did not improve outcomes in IA.