Similar patient-reported outcomes and performance after total knee arthroplasty with or without patellar resurfacing

Abstract

Background and purposeKnee pain after total knee arthroplasty (TKA) is not uncommon. Patellar retention in TKA is one cause of postoperative knee pain, and may lead to secondary addition of a patellar component. Patellar resurfacing in TKA is controversial. Its use ranges from 2% to 90% worldwide. In this randomized study, we compared the outcome after patellar resurfacing and after no resurfacing.Patients and methodsWe performed a prospective, randomized study of 74 patients with primary osteoarthritis who underwent a Triathlon CR TKA. The patients were randomized to either patellar resurfacing or no resurfacing. They filled out the VAS pain score and KOOS questionnaires preoperatively, and VAS pain, KOOS, and patient satisfaction 3, 12, and 72 months postoperatively. Physical performance tests were performed preoperatively and 3 months postoperatively.ResultsWe found similar scores for VAS pain, patient satisfaction, and KOOS 5 subscales at 3, 12, and 72 months postoperatively in the 2 groups. Physical performance tests 3 months postoperatively were also similar in the 2 groups. No secondary resurfacing was performed in the group with no resurfacing during the first 72 monthsInterpretationPatellar resurfacing in primary Triathlon CR TKA is of no advantage regarding pain, physical performance, KOOS 5 subscales, or patient satisfaction compared to no resurfacing. None of the patients were reoperated with secondary addition of a patellar component within 6 years. According to these results, routine patellar resurfacing in primary Triathlon TKA appears to be unnecessary.

Effect of Patellar Resurfacing on Clinical Outcomes, Range of Knee Motion and Anterior Knee Pain in Patients with Total Knee Arthroplasty

“…No significant difference was detected in either clinical or radiological results between the two groups (14). Another study with medium followup period found patellar resurfacing had no advantage on knee function and patient satisfaction (15). No significant difference in functional outcome was detected between patellar resurfacing and retention in a randomised controlled trial including 1715 patients (16).…”

Influence of femoral implant design modification on anterior knee pain and patellar crepitus in patients who underwent total knee arthroplasty without patella resurfacing

“…However, these studies did not enrol patients who underwent TKA without patellar resurfacing. Although many studies have suggested there is no significant difference in functional outcomes between procedures that incorporated patellar resurfacing and that those that did not in TKA [13][14][15], the probability of AKP was higher in TKA procedures performed without patellar resurfacing than those in which it was [16]. Whether TKA without patellar resurfacing benefits from this femoral implant design modification with regard to AKP and patellar crepitus remains unclear.…”

Sagittal Stability and Implant Design Affect Patient Reported Outcomes After Total Knee Arthroplasty

“…However, 10% to 34% of TKA patients remain dissatisfied with their knee [1]. It has been reported that a large proportion of revision surgeries after TKA are due to instability [2]. Patient factors such as anatomical variations in bony anatomy and alignment and pathological changes in soft tissues can leave some patients more prone to instability than others.…”