Patellar resurfacing versus nonresurfacing in total knee arthroplasty: A meta-analysis of randomised controlled trials

Abstract

Purpose Patella resurfacing or nonresurfacing in total knee arthroplasty remains controversial. The aim of this study was to evaluate the efficacy of patellar resurfacing through an evaluation of the current literature. Methods We carried out a meta-analysis of randomised controlled trials comparing total knee arthroplasties performed with and without patellar resurfacing. Outcomes of reoperation, anterior knee pain and knee scores were analysed. Results Fourteen trials assessing 1,725 knees were eligible. The absolute risk of reoperation was reduced by 4 % (95 % confidence interval, 2-6 %) in the patellar resurfacing arm (between-study heterogeneity, P=0.05, I 2 =42 %), implying that one would have to resurface 25 patellae (95 % confidence interval, 17-50 patellae) in order to prevent one reoperation.

Common controversies in total knee replacement surgery: Current evidence

“…In 2013, the randomized controlled trial by Pulavarti et al [47] shed more light on the subject of patellar denervation without resurfacing: the method appeared safe, and improved patient satisfaction and range of knee flexion but did not ameliorate validated knee scores in a followup of 2 years [45] . Finally, Chen et al [48] also in 2013, published a meta-analysis of randomized controlled trials which supported the point of view that patellar resurfacing reduced the risk of reoperation and, moreover, gave better results in Knee Society Score in a follow-up of 5 years or more, but the overall benefits of the method were not sufficient to convince the authors to prefer this method over patellar non-resurfacing [48] .…”

“…Chen et al [48] Meta-analysis of randomized controlled trials Patellar resurfacing vs nonresurfacing in primary TKR Patellar resurfacing reduces the risk of reoperation after TKR. No difference between the 2 groups in terms of anterior knee pain, knee pain score, Knee Society score and knee function score Pilling et al [44] Meta-analysis of randomized controlled trials.…”

Native Patella Retention Versus Resurfacing in a Cohort of Staged Bilateral Total Knee Patients

“…While some studies and meta-analysis have shown patella resurfacing to be better in terms of cost-effectiveness, reduced revision rate for anterior knee pain, and produced less anterior knee pain, emerging evidence suggests that resurfacing has no influence on the clinical outcome of the patient. [12][13][14][15][16][17] Proponents of retention of the native patella claim that it has no affect on total healthcare cost, reoperation rate or functional outcome and has a lower complication rate. [18][19][20][21] TKA is one of the most commonly performed operations in adult reconstructive surgery and there currently exists three different approaches among orthopedic surgeons regarding patellar resurfacing: resurfacing all patellae, not resurfacing all patellae, and selective resurfacing for patients with significant pre-operative patellofemoral arthritis-related symptoms and/or advanced patellofemoral arthritis on radiographs.…”

Does patellofemoral congruence following total knee arthroplasty correlate with pain or function? Intraoperative arthroscopic assessment of 30 cases

“…Anterior knee pain (AKP) is observed in TKA both with and without patellar resurfacing (5,6,8,9). Neither patellar denervation (4,10) nor secondary resurfacing (11,12) proved effective for treating the symptoms.…”