Should the patella be replaced in total knee replacement?

Badhe, Nitin P.; Dewnany, G.; Livesley, P. J.

doi:10.1007/s002640100225

Cited by 25 publications

(11 citation statements)

References 22 publications

(28 reference statements)

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“…Barrack et al [12] concluded that there was an approximately equal likelihood of developing anterior knee pain post-operatively regardless of whether patellar resurfacing is done, whereas Waters and Bentley [19], Wood et al [20] and Badhe et al [21] found that the resurfaced patella performed better. Reoperations for patellofemoral problems, anterior knee pain and pain during stair climbing occurred less frequently with the resurfaced patella [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Patella in total knee arthroplasty: to resurface or not to—a cohort study of staged bilateral total knee arthroplasty

Patel

Raut

2010

International Orthopaedics (SICOT)

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The aim of this study was to assess medium term results of patellar resurfacing in total knee arthroplasty, specifically looking at anterior knee pain, patellofemoral function and need for reoperation. A prospective cohort study was conducted with patients undergoing staged bilateral knee arthroplasty with the patella being resurfaced only on one side. This was due to change in the clinical practice of the senior author. Sixty patients were reviewed clinically and radiologically on a regular basis. The surgery was either performed or supervised by the senior author in all cases. All patients received the cemented press-fit condylar© prosthesis. The Knee Society clinical rating system was used. Scores were recorded pre-operatively and post-operatively at three months, one year, two years and three yearly thereafter. The mean age of patients in the study group was 75 years (range: 62-89 years). There were 42 women and 18 men in the study. The mean duration of follow-up was 4.5 years (range: 2-12 years). There was no significant difference in the pre-operative scores in both groups. There were significantly better scores (p < 0.05) on the resurfaced side as compared to the non-resurfaced side at final follow-up. No revision was carried out for patellofemoral complications on the resurfaced side. Four patients required revision in the form of patellar resurfacing on the non-resurfaced side for persistent anterior knee pain. Patellar resurfacing is recommended in total knee arthroplasty for better functional outcome with regards to anterior knee pain and patellofemoral function.

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Section: Discussionmentioning

confidence: 99%

Patella in total knee arthroplasty: to resurface or not to—a cohort study of staged bilateral total knee arthroplasty

Patel

Raut

2010

International Orthopaedics (SICOT)

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“…The role of patellar resurfacing has also been controversial in TKA. 1 However, prior studies have demonstrated that patellar resurfacing improves the results of TKA surgery, resulting in less pain and a lower reoperation rate. 12,21 If the patella construct is made too thick, "overstuffing" of the patellofemoral compartment will result, which theoretically may limit flexion.…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Postoperative Range of Motion After Total Knee Arthroplasty

Clarke²,

et al. 2010

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One hundred thirty five patients with osteoarthritis who underwent total knee arthroplasty (TKA) were evaluated to determine whether specific pre-and postoperative variables were correlated with the postoperative range of motion. Age, sex, pre-and postoperative range of motion, pre-and postoperative Knee Society scores, intraoperative patellar thickness before and after resurfacing, pre-and postoperative radiographic patellar height (as determined by the Insall-Salvati and Blackburn-Peel ratios), and preoperative radiographic alignment were recorded for each patient. Regression analysis was performed to identify whether any variables were correlated with the postoperative range of motion or Knee Society scores. The only variable that was significantly correlated with postoperative range of motion was the preoperative range of motion. This study suggests that among the variables evaluated, the preoperative range of motion was the only significant predictor of postoperative range of motion.

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“…That it is controversial to resurface the patella in total knee arthroplasty (TKA) remains as a topic in the literature because of the higher incidence of anterior knee pain after TKA without patellar resurfacing [1,2], which was reported to be between 5 and 47% of patients [3][4][5][6][7], and the general idea that the aetiology of anterior knee pain is related to the patellofemoral joint. Some authors recommend routinely resurfacing the patella [7][8][9][10][11], while others have reported no evidence to support routine patellar resurfacing.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of patellar resurfacing in total knee arthroplasty

Chen

et al. 2010

International Orthopaedics (SICOT)

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Controversies existing over resurfacing the patella in total knee arthroplasty remain in the literature. The purpose of this review was to evaluate the effectiveness of resurfacing versus nonresurfacing the patella in total knee arthroplasty. We searched the Cochrane Library, MEDLINE and EMBASE for published randomised clinical trials relevant to patellar resurfacing. The relative risk of reoperation was significantly lower for the patellar resurfacing group than for the nonresurfacing group (relative risk 0.57, 95% confidence interval 0.38-0.84, P=0.004). The overall incidence of postoperative anterior knee pain of the 1,421 knees included was 12.9% in the patellar resurfacing group and 24.1% in the nonresurfacing group. The existing evidence indicates that patellar resurfacing can reduce the risk of reoperation with no improvement in postoperative knee function or patient satisfaction over total knee arthroplasty without patellar resurfacing. Whether it can decrease the incidence of anterior knee pain remains uncertain.

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Should the patella be replaced in total knee replacement?

Cited by 25 publications

References 22 publications

Patella in total knee arthroplasty: to resurface or not to—a cohort study of staged bilateral total knee arthroplasty

Patella in total knee arthroplasty: to resurface or not to—a cohort study of staged bilateral total knee arthroplasty

Factors Affecting Postoperative Range of Motion After Total Knee Arthroplasty

Systematic review of patellar resurfacing in total knee arthroplasty

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