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Published on: January 24, 2018
A novel stepwise lateral patellar facetectomy technique in total knee arthroplasty: a comparative clinical and
Mehmet Özer1, Deniz Ardalı1, Murat Birinci1
1Umraniye Training and Research Hospital, Department of Orthopaedics and Traumatology, İstanbul, Türkiye.
Background:
Patellofemoral complications are a leading cause of dissatisfaction after total knee arthroplasty (TKA). While strategies such as patellar component implantation or patella-preserving techniques (osteophyte removal, denervation, lateral release) are commonly used, non of these techniques ensure complete patient satisfaction. Partial lateral facetectomy has been proposed to reduce lateral compartment pressure, prevent maltracking, and relieve anterior knee pain. This study compares the clinical and functional outcomes of patients who underwent lateral patellar facetectomy with osteophyte removal during TKA to those who received other patella-preserving methods (osteophyte removal ± denervation).
Methods:
Between 2018 and 2023, patients who underwent knee arthroplasty at the clinic with a minimum follow-up of 12 months were included. Patients were assigned to either osteophyte removal with lateral patellar facetectomy or osteophyte removal ± denervation. Exclusion criteria included any revision procedure, patellar component implantation, or prior correction of patellar alignment or deformity. Clinical outcomes were compared using the Knee Society Score (KSS), Oxford and Kujala scores. Pre- and postoperative standing AP, lateral, and Merchant radiographs were evaluated for patellar alignment.
Results:
A total of 203 patients were included, comprising 99 (48.8%) in the lateral patellar facetectomy (LPF) group and 104 (51.2%) in the non-LPF group. The LPF group demonstrated significantly lower patellar displacement, lateral displacement, congruence, and tilt angles (p < 0.05) and significantly higher KSS, Oxford, Kujala scores (p < 0.05) compared with the non-LPF group.
Conclusion:
Lateral patellar facetectomy improved patellofemoral congruence and was associated with better radiographic parameters and higher KSS, Oxford, and Kujala scores.
