OBJECTIVES: We evaluated the clinical and radiographic results of total knee arthroplasty (TKA) with or without patellar resurfacing. METHODS: The study included 149 knees of 126 patients who underwent TKA for primary knee osteoarthritis with (59 knees, group 1) or without (90 knees, group 2) patellar resurfacing. Clinical evaluations were made with the knee and function scores of the Knee Society, and patella scoring system; radiographic evaluations included changes in the joint line, Insall-Salvati ratio, lateral patellofemoral angle, and congruency angle. The mean follow-up period was 66.7 months (range 34 to 123 months) in group 1, and 68.1 months (range 30 to 117 months) in group 2. RESULTS: Although postoperative knee and function scores showed significant improvements in both groups (p<0.001), these did not reach significance between the two groups (p>0.05). The mean patella scores did not differ significantly, either (p>0.05). Postoperative radiographic assessments did not show significant differences between the two groups with respect to mechanical axis values, patellar tilt, and lateral subluxation (p>0.05). Symptomatic patellar subluxation, dislocation, fracture or rupture of the extensor mechanism did not occur in any of the treatment groups. None of the patients required revision associated with the patella and patellar prosthesis. CONCLUSION: Our findings suggest that patellar resurfacing is not necessary other than patients with significant degeneration of the patellar surface.
OBJECTIVES: We evaluated the clinical and radiographic results of total knee arthroplasty (TKA) with or without patellar resurfacing. METHODS: The study included 149 knees of 126 patients who underwent TKA for primary knee osteoarthritis with (59 knees, group 1) or without (90 knees, group 2) patellar resurfacing. Clinical evaluations were made with the knee and function scores of the Knee Society, and patella scoring system; radiographic evaluations included changes in the joint line, Insall-Salvati ratio, lateral patellofemoral angle, and congruency angle. The mean follow-up period was 66.7 months (range 34 to 123 months) in group 1, and 68.1 months (range 30 to 117 months) in group 2. RESULTS: Although postoperative knee and function scores showed significant improvements in both groups (p<0.001), these did not reach significance between the two groups (p>0.05). The mean patella scores did not differ significantly, either (p>0.05). Postoperative radiographic assessments did not show significant differences between the two groups with respect to mechanical axis values, patellar tilt, and lateral subluxation (p>0.05). Symptomatic patellar subluxation, dislocation, fracture or rupture of the extensor mechanism did not occur in any of the treatment groups. None of the patients required revision associated with the patella and patellar prosthesis. CONCLUSION: Our findings suggest that patellar resurfacing is not necessary other than patients with significant degeneration of the patellar surface.
Authors: Warren J Clements; Lisa Miller; Sarah L Whitehouse; Stephen E Graves; Philip Ryan; Ross W Crawford Journal: Acta Orthop Date: 2010-02 Impact factor: 3.717