Revision knee arthroplasty with patella replacement versus bony shell

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Revision total knee arthroplasty (TKA) is a complex procedure often requiring management of the patellofemoral joint.
• The decision to resurface or leave an unresurfaced bony shell after patellar component removal in revision TKA can impact clinical outcomes.

Purpose of the Study:

• To compare the clinical results of revision TKA when an unresurfaced bony shell was left versus when a patellar component was implanted.
• To evaluate patient satisfaction and functional outcomes based on patellar management during revision TKA.

Main Methods:

• A retrospective study of 130 consecutive revision TKAs across three centers.
• Patients were divided into two groups: those with an unresurfaced bony shell (n=21) and those with a new patellar component (n=92).
• Clinical outcomes, including postoperative knee scores, patient satisfaction, and functional ability (e.g., stair use), were assessed.

Main Results:

• The unresurfaced bony shell group had lower postoperative knee scores.
• Patients with an unresurfaced bony shell reported significantly more difficulty with stairs and lower satisfaction rates.
• A higher percentage of patients in the bony shell group rated their surgery as unsuccessful in restoring normal daily activities.

Conclusions:

• Leaving an unresurfaced bony shell during revision TKA is associated with inferior clinical results compared to patellar component implantation.
• Patellar component management is a critical factor influencing patient outcomes and satisfaction in revision knee arthroplasty.