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[Patellar substitution in total knee prosthesis--is it important?]
M P Arnold1, N F Friederich, H Widmer
1Klinik für Orthopädische Chirurgie und Traumatologie des Bewegungsapparates, Kantonsspital Bruderholz, Schweiz.
Der Orthopade
|November 12, 1998
Summary
Total Knee Arthroplasty (TKA) without patellar resurfacing shows excellent long-term outcomes. This approach preserves the patellofemoral joint, leading to favorable remodeling and functional results.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Context:
- The femoropatellar joint is a known issue in long-term Total Knee Arthroplasty (TKA) follow-up.
- This study investigates an alternative TKA technique focusing on the patellofemoral joint.
Purpose:
- To evaluate the long-term outcomes of primary Total Knee Arthroplasty (TKA) performed without patellar resurfacing.
- To assess the patellofemoral joint remodeling and clinical results of this TKA approach.
Summary:
- Over 700 consecutive TKAs using the De Puy New Jersey LCS prosthesis were performed between 1990 and 1997 without primary patellar resurfacing.
- A standardized lateral approach with tibial tuberosity osteotomy was employed, with the patella either denervated or left untouched.
- Radiographic analysis revealed significant patellar remodeling, aligning well with the femoral prosthesis design, indicating successful integration.
Impact:
- This blood-supply-preserving surgical approach, combined with a biomechanically sound implant, demonstrates excellent long-term results for TKA.
- The findings suggest that primary patellar resurfacing may not be necessary in all TKA cases, potentially simplifying the procedure and improving outcomes.