Total Knee Arthroplasty Without Patellar Resurfacing

Levitsky, Kenneth A.; HARRIS, WENDY J.; McManus, J; Scott, Richard D.

doi:10.1097/00003086-199301000-00018

Cited by 63 publications

(17 citation statements)

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“…A metal-backed patella was implanted in 170 cases, and an all-polyethylene component in 22 cases, leaving 43 osteoarthritic patellae which were not resurfaced. 30 The 'rule of no thumb' was used to estimate patellar tracking 31 and a lateral release performed in 109 of the 192 knees with patellar resurfacing and in 11 of those without (Table III).…”

Section: Methodsmentioning

confidence: 99%

Total knee arthroplasty with the PFC system

Schai

Thornhill²,

Scott

1998

The Journal of Bone and Joint Surgery

161

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A consecutive series of 235 total knee arthroplasties using the PFC system was followed prospectively for at least ten years in 186 patients. The operation was for osteoarthritis in 150 knees, for rheumatoid arthritis in 83, and for Paget's disease and femoral osteonecrosis in one knee each. At the latest review 56 patients had died, five were too ill to assess and three could not be traced. The PFC knee replacement utilised was a non-conforming posterior-cruciate-retaining prosthesis with a polyethylene insert which is flat in the sagittal plane. The patella was resurfaced using a metal-backed component in 170 cases, but later in the series we used an all-polyethylene component in 22 knees; 43 patellae were not resurfaced. The survival without need for reoperation for any reason was 90% at ten years. Nineteen revisions were component-related due to failure of nine metal-backed patellae, nine polyethylene inserts, and one unresurfaced patella; two reoperations were for synovectomy (one for recurrent haemarthrosis and one for recurrent rheumatoid synovitis) and three were for metastatic joint infection. There were no revisions for aseptic loosening of femoral or tibial components, or the all-polyethylene patellar replacement. The PFC system provides good and predictable results in tricompartmental arthritis of the knee. Loosening appeared to be negligible, but there were wear-related problems in 8%. The change from a metal-backed patella and an increase in the contact area of the tibial insert should provide further improvement by minimising wear.

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Section: Methodsmentioning

confidence: 99%

Total knee arthroplasty with the PFC system

Schai

Thornhill²,

Scott

1998

The Journal of Bone and Joint Surgery

161

View full text Add to dashboard Cite

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“…This attempt is also necessary in order to avoid potential complications associated with unnecessary resurfacing [25][26][27][28][29][30][31][32]. The authors who support this procedure consider many patient-and prostheses-related factors as certain prerequisites in favor of the intervention.…”

Section: Discussionmentioning

confidence: 99%

Knee Arthroplasty: With or Without Patellar Component?

Solyom¹,

Ildikó

Csaba

et al. 2015

Acta Medica Marisiensis

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Arthroplasty is used when there is irreversible damage to the articular cartilage of the knee. It involves implanting a bicompartimental (femoral and tibial components) or a tricompartimental (femoral, tibial and patellar components) prosthesis. It is a very invasive and costly operation, so our objective was to evaluate the necessity of the patellar component. Material and methods: During our study we've included 39 patients: in 27 cases we used tricompartimental prosthesis, while the other 12 received only the bicompartimental components. Patients were evaluated preoperatively and postoperatively using the International Knee Documentation Comitee score. We've also compared our results with the results of other published authors. Results: We've found that there is little to no difference between the two groups regarding mobility and complication, however patients with bicompartimentalarthroplasty complained of less pain. Conclusion: We've found that bicompartimentalarthroplasty -being a less invasive procedure -is better not only in terms of pain management, but there is also less hemorrhaging, shorter intraoperative time is considered, revision is easier and also has financially advantages, both for the patient and for the medical facility.

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“…Meinungsunterschiede bestehen aber bezüglich der Notwendigkeit, jüngere Patienten mit noch intaktem Knorpel mit einem Patellaersatz zu versorgen. Einige Autoren befürworten grundsätzlich bei jeder Prothesenimplantation den Ersatz der Kniescheibenrücktläche [12][13][14], während andere ein selektives Vorgehen propagieren [1,3,7,8,9,11,18).…”

Section: Introductionunclassified

“…Nachdem wir bis 1992 obligatorisch bei jedem Miller-Galante-Obertlächenersatz die Kniescheibenrückfläche ersetzten, war unser Vorgehen in den letzten Jahren bedingt durch patellafemorale Spätkomplikationen und ermutigt durch Publikationen, die positive mittelfristige Ergebnisse bei Alloarthroplastiken des Kniegelenkes ohne Ersatz der Patellarücktläche berichten [7,9,17], selektiver.…”

Section: Introductionunclassified