Knee function after patellectomy. A 12- to 48-year follow-up

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Musculoskeletal research

Background:

• Patellectomy, the surgical removal of the kneecap, has been performed for various knee conditions.
• Long-term outcomes and functional impact of patellectomy are not fully elucidated.
• Previous studies have shown variable results depending on the indication for surgery.

Purpose of the Study:

• To evaluate the long-term functional outcomes and patient satisfaction following patellectomy.
• To compare the results of patellectomy for different indications: anterior knee pain, patellofemoral osteoarthritis, and comminuted fractures.
• To assess the impact of patellectomy on quadriceps muscle strength and knee function.

Main Methods:

• Retrospective case series of 83 knees (69 patients) undergoing patellectomy between 1942 and 1978.
• Patient-reported outcomes including symptoms and function assessed 14-50 years post-operation.
• Objective functional assessment in a subset of 16 patients using dynamometry, ultrasound, and radiography.

Main Results:

• 76% of patients with anterior knee pain reported good results and satisfaction.
• Only 54% of patients with patellofemoral osteoarthritis experienced satisfactory pain relief, with functional decline.
• Average quadriceps muscle power was 60% of the contralateral limb in unilateral cases, with significant variability.

Conclusions:

• Patellectomy can be an effective treatment for chronic anterior knee pain, yielding high patient satisfaction.
• Patellectomy is less successful for patellofemoral osteoarthritis, often leading to persistent pain and functional impairment.
• Significant long-term reduction in quadriceps strength is a common consequence of patellectomy, impacting overall knee function.