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Published on: January 24, 2018
Total knee arthroplasty in patellectomized patients
J D Kang1, S N Papas, H E Rubash
1University of Pittsburgh, Department of Orthopaedic Surgery, Falk Clinic, Pennsylvania.
The Journal of Arthroplasty
|October 1, 1993
Summary
Total knee arthroplasty (TKA) in patellectomized patients showed generally satisfactory outcomes, with lower function scores but acceptable pain relief and low failure rates. Both primary and revision TKAs yielded positive results, even without a patella.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Reconstructive Surgery
Background:
- Patellectomy, the surgical removal of the patella, presents unique challenges in total knee arthroplasty (TKA).
- Understanding the long-term outcomes of TKA in patients who have undergone prior patellectomy is crucial for surgical planning and patient expectations.
Purpose of the Study:
- To evaluate the clinical and radiographic outcomes of primary and revision total knee arthroplasties in patients with a history of patellectomy.
- To compare the results of TKAs in patellectomized patients with a matched control group of TKA patients with intact patellae.
Main Methods:
- Retrospective evaluation of 32 TKAs in patellectomized patients (18 primary, 14 revision) using clinical and radiographic examinations.
- Comparison with a matched control group of 13 TKA patients with intact patellae.
- Assessment using the Knee Society's clinical and radiographic scoring system and isokinetic dynamometer testing for quadriceps and hamstring torque.
Main Results:
- Patellectomized patients had lower average function scores (59.7 primary, 60.0 revision) compared to controls (80.9), primarily due to difficulties with stair ambulation.
- Knee scores (pain relief) were comparable between primary (82.5) and revision (86.5) patellectomized groups, and generally satisfactory.
- Failure rates were low (one in primary, one in revision), with no radiographic signs of impending failure in remaining knees.
Conclusions:
- Total knee arthroplasty in patellectomized patients yields generally satisfactory results, particularly regarding pain relief, despite functional deficits.
- Primary TKAs with posterior cruciate ligament-retaining prostheses and revision TKAs with posterior cruciate ligament-substituting prostheses demonstrated successful outcomes in this cohort.
- The study highlights the importance of managing patient expectations regarding functional recovery, especially concerning stair climbing, after TKA with patellectomy.
