Patellar resurfacing in total knee arthroplasty: functional outcome differs with different outcome scores

Abstract

Background and purpose — Recent research on outcomes after total knee arthroplasty (TKA) has raised the question of the ability of traditional outcome measures to distinguish between treatments. We compared functional outcomes in patients undergoing TKA with and without patellar resurfacing, using the knee injury and osteoarthritis outcome score (KOOS) as the primary outcome and 3 traditional outcome measures as secondary outcomes.Patients and methods — 129 knees in 115 patients (mean age 70 (42–82) years; 67 female) were evaluated in this single-center, randomized, double-blind study. Data were recorded preoperatively, at 1 year, and at 3 years, and were assessed using repeated-measures mixed models.Results — The mean subscores for the KOOS after surgery were statistically significantly in favor of patellar resurfacing: sport/recreation, knee-related quality of life, pain, and symptoms. No statistically significant differences between the groups were observed with the Knee Society clinical rating system, with the Oxford knee score, and with visual analog scale (VAS) for patient satisfaction.Interpretation — In the present study, the KOOS—but no other outcome measure used—indicated that patellar resurfacing may be beneficial in TKA.

Have the Causes of Revision for Total and Unicompartmental Knee Arthroplasties Changed During the Past Two Decades?

“…The use of patella resurfacing was lower in Period 2, probably owing to previous studies showing no difference in functional outcomes and risk of revision for resurfaced and nonresurfaced TKAs in Norway, the United Kingdom, and Sweden [24,35,43,44,61]. However, patella-resurfaced implants had a lower risk of revision in meta-analyses [10,54] and improved functional outcomes in a recent Norwegian randomized controlled trial for NexGen 1 cruciate-retaining prosthesis [3]. The threshold for revising a TKA resulting from unexplained pain may be lower for nonresurfaced implants, but secondary patella resurfacing gives little improvement in pain and satisfaction [38,71] and should not be recommended for most patients.…”

Patellar Resurfacing Does Not Improve Clinical Outcome in Patients with Symptomatic Tricompartmental Knee Osteoarthritis. An RCT Study of 40 Patients Receiving Primary Cruciate Retaining Total Knee Arthroplasty

“…Our results are in agreement with a recent RCT with a follow-up of 72 months that also failed to demonstrate benefits of patellar resurfacing regarding VAS for pain, KOOS, and patient satisfaction in a group of 74 patients with primary knee OA who underwent Triathlon CR TKA with or without patellar resurfacing. In their study group 15 Earlier, Feller et al performed a prospective study with a self-made specific score for PF joint OA. AKP, quadriceps strength, ability to rise from chair, and stair-climbing were incorporated in this score.…”

No detrimental effect of ligament balancing on functional outcome after total knee arthroplasty: a prospective cohort study on 129 mechanically aligned knees with 3 years’ follow-up

“…All patients participating in another prospective, randomized, and double-blind study comparing TKA with and without patellar resurfacing (Aunan et al. 2016 ) were included in this study. Inclusion criteria were patients less than 85 years old scheduled for TKA because of osteoarthritis.…”