Patellar Resurfacing in Total Knee Arthroplasty: Systematic Review and Meta-Analysis

Longo, Umile Giuseppe; Ciuffreda, Mauro; Mannering, Nicholas; D’Andrea, Valerio; Cimmino, Matteo; Denaro, Vincenzo

doi:10.1016/j.arth.2017.08.041

Cited by 83 publications

(82 citation statements)

References 47 publications

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“…Patellar resurfacing is a topic of continued debate in knee arthroplasty because empirical evidence shows equivocal outcomes compared with nonresurfacing. Advantages of patellar resurfacing include a lower reoperation rate because of less knee pain after surgery and better 2-year postoperative Knee Society clinical scores [41][42][43] ; however, disadvantages include fracture, hardware failure, and revision difficulty. 44 Spencer et al 12 retrospectively compared the outcomes of 169 TKA procedures in 110 patients with circumferential patellar denervation (83 TKA) versus patellar resurfacing (86 TKA).…”

Section: Patellar Resurfacing Versus Nonresurfacingmentioning

confidence: 99%

Kneeling after Total Knee Arthroplasty

2019

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The ability to kneel is one of the many patient goals after total knee arthroplasty (TKA). Few studies have addressed patients' ability to kneel after TKA as a primary outcome. Given the altered biomechanics of the knee after TKA, the various implant designs, and multiple surgical approaches, there is a need to further understand the patient's kneeling ability after TKA. We evaluated the available literature on this topic to help to guide postoperative care recommendations. Biomechanical data show that the load borne by the patellofemoral joint is elevated significantly at all flexion angles, whereas tibiofemoral articulation pressures are elevated only at 90 to 120 degrees of flexion. However, these increased pressures are rarely borne by prosthetic knees because patients often avoid kneeling after TKA. In patients who do kneel after surgery, data show that increased range of motion promotes improved kneeling performance. Targeted interventions to encourage kneeling after TKA, including preoperative education, have not shown an ability to increase the frequency with which patients kneel after TKA. Reasons for patient avoidance of kneeling are multifaceted and complex. There is no biomechanical or clinical evidence contraindicating kneeling after TKA. There are insufficient data to recommend particular prosthetic designs or surgical approaches to maximize kneeling ability after surgery. Musculoskeletal health care providers should continue to promote kneeling to allow patients to achieve maximum clinical benefit after TKA.

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Section: Patellar Resurfacing Versus Nonresurfacingmentioning

confidence: 99%

Kneeling after Total Knee Arthroplasty

2019

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“…However, in a recent study, it was found that anterior knee pain was less common in patients who underwent patellar surface change than those who did not. In the same study, the causes of PF joint revision were more common in patients without patella surface changes [166].…”

Section: Patellofemoral Joint Problemsmentioning

confidence: 72%

Complications after Total Knee Arthroplasty

Ayas¹,

Kalkışım²,

Köse³

et al. 2020

Knee Surgery - Reconstruction and Replacement

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Nowadays, the incidence of knee arthritis increases with the prolongation of human life and the increase in world population. As a result, total knee arthroplasty application rates increased and surgeons gained more experience. There have also been technical advances and total knee arthroplasty operations have been performed using better implants. However, despite these developments, the number and variety of complications are increasing. In addition to performing total knee arthroplasty correctly, it is now becoming more important to recognize complications that may or may develop. Variety of complications after total knee replacement; from minor skin problems to life-threatening complications. In this review article, we aimed to investigate early and late complications during and after total knee replacement surgery.

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“…Moreover, the resurfacing group revealed a significantly higher postoperative knee society score pain and postoperative hospital for special surgery score. Accordingly, they concluded that patellar resurfacing group outperformed the non-resurfaced group, and thus resurfacing is the more effective option (7).…”

Section: Discussionmentioning

confidence: 99%

“…Proponents of patellar resurfacing point out the advantages such as cost-effectiveness, better functional outcomes, less anterior knee pain, and lower number of reoperations. Advocates of patellar retention believe that patellar resurfacing entails a higher risk of patellar fracture, dislocation, patellar tendon injury, and patellar component loosening (7). Moreover, the latter group believes that resurfacing offers no benefit in functional outcomes, reoperation rate, and total health-care cost (8).…”

Section: Introductionmentioning

confidence: 99%

Patellar Resurfacing Versus Patellar Nonreusrfacing in Total Knee Arthroplasty: A Retrospective Study

Fakharian¹,

Bagherifard²,

Khorrami³

et al. 2018

J Orthop Spine Trauma

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Background: Patellar resurfacing in total knee arthroplasty (TKA) is a matter of long-standing debate and there is no consensus regarding the superiority of either patellar resurfacing or patellar nonresurfacing. Objectives: We aimed to compare the outcomes of patellar resurfacing with patellar nonresurfacing in a cohort of knee OA patients sustaining a TKA. Methods: In this retrospective study, patients who had undergone TKA between 2001 and 2011 in two hospitals in Tehran, Iran, were included. The Persian version of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to quantify the health status of patients. Post-operative complications and rate of reoperation were also compared between the two study groups. Results: The study population consisted of 89 patients in the resurfacing and 72 patients in the nonresurfacing groups. The demographic characteristics of the patients were not significantly different. The mean total WOMAC scores were 19.1 ± 8.8 and 19.6 ± 9.7 for the resurfacing and nonresurfacing groups (P = 0.55). No significant difference was observed between the mean WOMAC subscale scores of the two study groups including pain (P = 0.73), stiffness (P = 0.24), and physical function (P = 0.84). Two reoperations (2.2%) were performed in the resurfacing group and one (1.4%) in the nonresurfacing group. Conclusions: The health status and rate of reoperation were not considerably different between the patellar resurfacing and nonresurfacing groups. These results reveal that patellar resurfacing is not necessary in TKA.

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Patellar Resurfacing in Total Knee Arthroplasty: Systematic Review and Meta-Analysis

Cited by 83 publications

References 47 publications

Kneeling after Total Knee Arthroplasty

Kneeling after Total Knee Arthroplasty

Complications after Total Knee Arthroplasty

Patellar Resurfacing Versus Patellar Nonreusrfacing in Total Knee Arthroplasty: A Retrospective Study

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