Resurfaced versus Non-Resurfaced Patella in Total Knee Arthroplasty

Abstract

The prevalence of knee osteoarthritis is increasing, as is the projected use of total knee arthroplasty (TKA) to treat severe cases that fail to respond to conservative measures. Implant designs are either cruciate retaining or posterior stabilized, and while both have high success rates, management of the patella still remains a controversial topic. Although studies indicate that resurfacing the patella provides no significant clinical differences compared with non-resurfacing techniques, surgeons continue to resurface the patella during TKA. Rates of patella resurfacing continue to be as high as 90% in the United States, while European countries tend to favor non-resurfacing techniques. The purpose of this article is to discuss relevant research on patella resurfacing during TKA, to compare the results, and give evidence-based recommendations on how it should be approached going forward.

Multimodal Analgesia for Accelerated Rehabilitation after Total Knee Arthroplasty: A Randomized, Double-Blind, Controlled Trial on the Effect of the Co-Application of Local Infiltration Analgesia and Femoral Nerve Block Combined with Dexmedetomidine

“…Total knee arthroplasty (TKA) is a highly effective way to treat end-stage and severe arthritis [ 5 , 6 ]. It improves the function of the knee joint and quality of life.…”

Resuperficialización de la rótula en el reemplazo primario total de rodilla: estudio comparativo a dos años de seguimiento

“…Se incluyeron 206 RTR en el análisis: 94 en el grupo con resuperficialización y 112 en el grupo sin resuperficialización. La media de la edad en la cohorte de estudio era de 66.9 ± 9.7 años y el 76,7% (n = 155) eran mujeres, con un índice de masa corporal de 28,4 kg/m 2 (RIC 25, 6). Como se describe en la Tabla 1, no se observaron diferencias estadísticamente significativas entre los grupos respecto a la edad, el sexo y el índice de masa corporal (p >0,05).…”

“…3,4 La resuperficialización de la rótula durante un RTR sigue siendo un motivo de discrepancia entre los cirujanos, las tasas de uso oscilan entre el 2% y el 90%. 5,6 La decisión de resuperficializar o no la rótula se ha dejado principalmente en manos del cirujano, ya que la evidencia comunicada no es contundente respecto a su impacto en los resultados funcionales y las tasas de revisión. 3,5 Por ejemplo, en el metanálisis de Longo y cols., se hallaron mejores puntuaciones en las escalas funcionales, así como una tasa de revisión más baja en pacientes sometidos a un RTR con resuperficialización de la rótula.…”

Preservar ou substituir a patela durante a artroplastia total de joelho: Estudo comparativo

“…[11][12][13] Adicionalmente, ainda há aqueles que defendem a substituição patelar em casos selecionados e acreditam que a realização de rotina não é sustentada pela literatura. 14 O presente estudo tem como objetivo avaliar funcionalmente indivíduos submetidos a ATJ primária do joelho com a substituição da superfície articular da patela e compará-los a indivíduos em quem a superfície articular da patela foi preservada.…”

“…[11][12][13] Additionally, some still recommend patellar replacement in selected cases, believing that its routine performance is not supported by the literature. 14 The present study aims to functionally evaluate subjects submitted to primary TKA with patellar joint resurfacing and to compare them with patients in whom the patellar joint surface was retained.…”