Resurfacing versus not resurfacing the patella during total knee replacement

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Knee biomechanics

Background:

• Osteoarthritis of the knee is a common condition requiring surgical intervention.
• Total knee replacement (TKR) is a standard treatment for advanced knee osteoarthritis.
• The role of patellar resurfacing during TKR remains a subject of clinical debate.

Purpose of the Study:

• To compare the clinical outcomes of patellar resurfacing versus non-resurfacing in patients undergoing total knee replacement.
• To evaluate the impact of patellar management on pain, function, and strength after TKR.

Main Methods:

• A randomized controlled trial involving 100 patients with osteoarthritic knees.
• Patients were randomized to either patellar resurfacing or non-resurfacing during TKR.
• Outcomes assessed included the Knee Society Clinical Rating System, 30-second stair climb, and knee torque measurements at baseline and 2-year follow-up.

Main Results:

• Two patients in the non-resurfaced group required reoperation for anterior knee pain.
• At 2-year follow-up, the non-resurfaced group reported significantly less anterior knee pain.
• The non-resurfaced group also demonstrated significantly better knee flexor torques compared to the resurfaced group.

Conclusions:

• Patellar non-resurfacing in TKR may lead to reduced anterior knee pain and improved knee flexor strength at 2 years.
• Functional scores and knee extensor strength were similar between groups.
• Further long-term follow-up is warranted, but these findings suggest a need for continued evaluation of patellar resurfacing indications.