PURPOSE: The ideal management of the patella during total knee arthroplasty (TKA) is still controversial. Patellar retention is generally associated with an increased rate of anterior knee pain; however, patient satisfaction is similar in cases of replacement or retention. When the patella is replaced, potential severe complications can occur. Aim of this study was to retrospectively review results of a continuous series of patients having been treated with TKA and patella resurfacing. METHODS: The charts of 1,600 consecutive total knee prostheses were analysed to evaluate the rate of patellar resurfacing. All implants were posterior stabilized; 310 patients having received a patellar replacement were reviewed at follow-up (FU) examination. Complete physical examination as well as administration of the Hospital for Special Surgery (HSS) score was performed. X-rays analysis included weightbearing anteroposterior (AP) and lateral views of the injured knee and bilateral skyline views at 30° flexion. RESULTS: Two hundred and eighty patients were available for clinical and imaging investigation at an average FU of 96 (58-144) months. Mean age at the time of surgery was 70 (62-80) years. Mean HSS score was 85.9 ± 7.6. The overall rate of patellofemoral complications was 7% (19 cases); 13 patients claimed anterior knee pain, five had symptomatic patellar maltracking and one had patellar component loosening. CONCLUSION: Our data are in accordance with those available in the literature. Recent meta-analyses demonstrated lower risk of re-operation after patellar resurfacing. However, when complications of the resurfaced patella occur, they can be potentially catastrophic events.
PURPOSE: The ideal management of the patella during total knee arthroplasty (TKA) is still controversial. Patellar retention is generally associated with an increased rate of anterior knee pain; however, patient satisfaction is similar in cases of replacement or retention. When the patella is replaced, potential severe complications can occur. Aim of this study was to retrospectively review results of a continuous series of patients having been treated with TKA and patella resurfacing. METHODS: The charts of 1,600 consecutive total knee prostheses were analysed to evaluate the rate of patellar resurfacing. All implants were posterior stabilized; 310 patients having received a patellar replacement were reviewed at follow-up (FU) examination. Complete physical examination as well as administration of the Hospital for Special Surgery (HSS) score was performed. X-rays analysis included weightbearing anteroposterior (AP) and lateral views of the injured knee and bilateral skyline views at 30° flexion. RESULTS: Two hundred and eighty patients were available for clinical and imaging investigation at an average FU of 96 (58-144) months. Mean age at the time of surgery was 70 (62-80) years. Mean HSS score was 85.9 ± 7.6. The overall rate of patellofemoral complications was 7% (19 cases); 13 patients claimed anterior knee pain, five had symptomatic patellar maltracking and one had patellar component loosening. CONCLUSION: Our data are in accordance with those available in the literature. Recent meta-analyses demonstrated lower risk of re-operation after patellar resurfacing. However, when complications of the resurfaced patella occur, they can be potentially catastrophic events.
Authors: R Stephen J Burnett; Julienne L Boone; Seth D Rosenzweig; Karen Steger-May; Robert L Barrack Journal: J Bone Joint Surg Am Date: 2009-11 Impact factor: 5.284
Authors: Mauricio Etchebehere; Patrick P Lin; Justin E Bird; Robert L Satcher; Bryan S Moon; Jun Yu; Liang Li; Valerae O Lewis Journal: J Bone Joint Surg Am Date: 2016-04-06 Impact factor: 5.284
Authors: Thomas Comfort; Valborg Baste; Miquel Angel Froufe; Robert Namba; Barbara Bordini; Otto Robertsson; Guy Cafri; Elizabeth Paxton; Art Sedrakyan; Stephen Graves Journal: J Bone Joint Surg Am Date: 2014-12-17 Impact factor: 5.284