Comparison of Clinical Outcomes between Patella Resurfacing VersusNon-Resurfacing in Primary Total Knee Arthroplasty-AProspective Study of 360 Cases (original) (raw)
Related papers
2018
Background There is no difference in the functional outcomes 6 months after total knee arthroplasty (TKA) for knee osteoarthritis between patellar resurfacing and non-resurfacing. Thus, we have performed this study to compare the short-term clinical outcomes of TKA performed with and without the patella resurfacing. Methods A total of 50 patients with osteoarthritis of the knee (OAK) were randomized to receive patellar resurfacing (n=24; resurfaced group) or to retain their native patella (n=26; non-resurfaced group) based on envelope selection and provided informed consent. Disease specific outcomes including Knee Society Score (KSS), Knee Society Function Score (KSKS-F), Kujala Anterior Knee Pain Scale (AKPS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Short Form 36 (SF-36), and functional patella-related activities were measured within six months of follow-up. Results There was no significant difference between the resurfaced and non-resurfaced groups in p...
2018
Total Knee Arthroplasty (TKA) has been a very successful surgery in relieving pain and restoring function in osteoarthritis. Conflicting evidence in literature exists regarding the merits of patellar resurfacing during TKA over non-resurfacing. Our aim is to evaluate and compare the difference between patellar resurfaced group and non-resurfaced group in primary TKA. Materials and Methods: This prospective obsevational study was initiated in May 2016 conducted till April 2008 (2 years) in Yashoda Superspeciality Hospital, Hyderabad. At least 14 mm of patella was ensured to be retained after patellar cut. A total of 40 patients were allocated to receive (n=20) or not to receive patellar resurfacing (n=20) during primary TKA. The data was analyzed statistically using the Student t test. Overall patient satisfaction was recorded using the SF-36 score. Results: Of the 40 patients, 67.5% females and 32.5 % males underwent TKA. Among those who underwent resurfacement, 40% were males. 75% among the non-resurfaced group were females. Right knee was operated on 37.5% of cases. Mean operative time being 103.9 and 122.5 minutes in nonresurfaced and resurfaced cases respectively. Mean patellar thickness was 22.1mm in nonresurfaced and 23.6mm in resurfaced group. The difference in VAS score, modified HSS score, KSS scores between the two groups were statistically insignificant with p-values of 0.230, 0.0214, 0.2513 respectively at the end of two year, but there was significant reduction of anterior knee pain in the resurfaced with p-value < 0.001. Conclusion: The functional outcome was not affected by whether the patella was resurfaced or nonresurfaced. There was no significant difference between the two groups with respect to the prevalence of knee-related readmission, or of subsequent patella-related surgery or patients overall satisfaction. We recommend selective patellar resurfacing at the time of primary total knee replacement.
Effect of patella resurfacing on functional outcome and revision rate in primary total knee arthroplasty (Review), 2022
Anterior knee pain, as well as patellofemoral disorders, after total knee arthroplasty are important reasons for revision in total knee arthroplasty. Current prosthesis designs include patellar components for patella replacement, and together with improved rational design of the prosthesis and advancement in knee alignment these appear to reduce the incidence of anterior knee pain following total knee replacement, even if the etiology of anterior knee pain remains unclear. However, new complications related to patella resurfacing emerge with this approach. At present, there are three strategies involving patella replacement in total knee arthroplasty: There are surgeons who always replace the patella, others who never resurface the patella and a third group of surgeons who usually do not resurface the patella but replace the patella in particular situations. There are arguments to support each of these viewpoints regarding patella resurfacing but no strong arguments to favor any of them. Finally, the decision to resurface the patella or not should be based on the practice, training and experience of individual surgeons. The aim of this review was to analyze the results of different strategies for patella resurfacing in terms of functional outcome and revision rate following primary total knee arthroplasty.
Patellar Resurfacing in Total Knee Arthroplasty
2001
Background: The management of the patella in total knee arthroplasty is still problematic. We aimed to identify differences in the clinical outcome of total knee arthroplasty according to whether or not patellar resurfacing had been performed in a prospective, randomized study of 220 osteoarthritic knees.
Evidence in orthopaedics: patellar resurfacing in total knee arthroplasty
Journal of Orthopaedics and Traumatology, 2004
Four good quality randomized clinical trials comparing patellar resurfacing versus noresurfacing in knee arthroplasty are analyzed. The outcomes evaluated were anterior knee pain, scores on the Knee Society’s rating system and reoperation. No relevant differences were found in knee scores, but anterior knee pain was less frequent in patients with patellar resurfacing. Few patients had severe anterior knee pain. Still, patients with anterior knee pain were less satisfied with the clinical result. Studies with longer follow-up showed that anterior knee pain increased with time in both groups. A clinically relevant increase in reoperation rate in the nonresurfaced group could not be excluded with the numbers available. Anterior knee pain seems to be influenced by the decision of resurfacing the patella during knee arthoplasty. Although it is not associated with important changes in knee scores, patients perceive it as a cause of insatisfaction. Influence of patellar resurfacing on implant supervivence is not clear.
Indian journal of orthopedics surgery, 2021
Total Knee Arthroplasty (TKA) has been a very successful surgery in relieving pain and restoring function in osteoarthritis. Conflicting evidence in literature exists regarding the merits of patellar resurfacing during TKA over non-resurfacing. Our aim is to evaluate and compare the difference between patellar resurfaced group and non-resurfaced group in primary TKA. Materials and Methods: This prospective obsevational study was initiated in May 2016 conducted till April 2008 (2 years) in Yashoda Superspeciality Hospital, Hyderabad. At least 14 mm of patella was ensured to be retained after patellar cut. A total of 40 patients were allocated to receive (n=20) or not to receive patellar resurfacing (n=20) during primary TKA. The data was analyzed statistically using the Student t test. Overall patient satisfaction was recorded using the SF-36 score. Results: Of the 40 patients, 67.5% females and 32.5 % males underwent TKA. Among those who underwent resurfacement, 40% were males. 75% among the non-resurfaced group were females. Right knee was operated on 37.5% of cases. Mean operative time being 103.9 and 122.5 minutes in nonresurfaced and resurfaced cases respectively. Mean patellar thickness was 22.1mm in nonresurfaced and 23.6mm in resurfaced group. The difference in VAS score, modified HSS score, KSS scores between the two groups were statistically insignificant with p-values of 0.230, 0.0214, 0.2513 respectively at the end of two year, but there was significant reduction of anterior knee pain in the resurfaced with p-value < 0.001. Conclusion: The functional outcome was not affected by whether the patella was resurfaced or nonresurfaced. There was no significant difference between the two groups with respect to the prevalence of knee-related readmission, or of subsequent patella-related surgery or patients overall satisfaction. We recommend selective patellar resurfacing at the time of primary total knee replacement.
Resurfacing versus not resurfacing the patella in total knee arthroplasty
The Journal of Arthroplasty, 2003
Patellar resurfacing in total knee arthroplasty is a topic debated in the literature. Concerns include fracture, dislocation, loosening, and extensor mechanism injury. Residual anterior knee pain has been reported when the patella is not resurfaced. One hundred patients with osteoarthritic knees were prospectively randomized to either have their patella resurfaced or left not resurfaced. All patients were treated with a single prosthesis that featured an anatomically designed patellofemoral articulation (Anatomic Medullary Knee, DePuy, Warsaw, IN) Two patients in the unresurfaced group and one in the resurfaced group required repeat surgery for patellofemoral complications. At 8-to 10-year follow-up evaluations, Knee Society Clinical Ratings scores were not different between the 2 groups. Rates of anterior knee pain with walking and stair climbing were significantly less in the resurfaced group. Eighty percent of patients with a resurfaced patella were extremely satisfied with their total knee arthroplasty versus 48% without patellar resurfacing. When satisfied and extremely satisfied patients were grouped together, there was no difference between the 2 groups.
Patellar resurfacing versus retention in total knee arthroplasty. J Bone Joint Surg Br 78-B:226-228
The Bone & Joint Journal
We studied 40 patients in whom the patella was not severely deformed and who were undergoing primary total knee arthroplasty (TKA) for osteoarthritis by one surgeon using one type of prosthesis. They were randomly allocated either to have the patella retained or resurfaced with a cemented, all-polyethylene component regardless of the state of the patellar articular cartilage. Apart from removal of osteophytes, no surgery was undertaken on the retained patellae. All 38 surviving patients were evaluated at three years using the HSS knee score and a new, specifically designed Patellar score (maximum score of 30). No TKA was revised, but two patients in the resurfacing group had a further unrelated procedure.
Early outcomes of patella resurfacing in total knee arthroplasty
Acta Orthopaedica, 2010
Background Patella resurfacing in total knee arthroplasty is a contentious issue. The literature suggests that resurfacing of the patella is based on surgeon preference, and little is known about the role and timing of resurfacing and how this affects outcomes.
Patellar Resurfacing in Primary Total Knee Replacement
The Journal of Bone and Joint Surgery-American Volume, 2012
Background: Treatment of the patella during total knee replacement is an area of continuing debate. We performed a meta-analysis of randomized controlled trials to address the hypothesis that patellar resurfacing in primary total knee replacement improved patient outcome. IVIethods: Randomized controlled trials comparing patellar resurfacing with nonresurfacing in primary total knee replacement were included. The primary outcomes analyzed were knee scores, anterior knee pain, and patient satisfaction. We also investigated the prevalence of complications, revision surgery related specifically to the patellofemoral joint, the infection rate, operative time, and radiographie appearance. Results: Sixteen randomized controlled trials assessing 3465 knee replacements were eligible; 1710 procedures included patellar resurfacing and 1755 did not. The knee component of the Knee Society Score was significantly higher in the resurfacing group (p = 0.005); however, no significant difference was observed forthe function component of the Knee Society Score or for any other reported knee score. Anterior knee pain was reported in 13% of resurfaced knees and in 24% of nonresurfaced knees; this difference was not significant (p = 0.1). Patients were satisfied with the outcome after 485 (90%) of 539 procedures that included patellar resurfacing compared with 488 (89%) of 548 that did not; this difference was not significant. There were ninety-three reported patellofemoral complications in the resurfacing group and 205 in the nonresurfacing group; this difference was significant (p = 0.02) in a random-effect model. The rate of reoperation because of anterior knee pain (p < 0.00001) and the rate of reoperation because of any patellofemoral complication (p = 0.002) were significantly higher in the nonresurfaced group. No differences were found in the analyses of infection rate, operative time, or radiographie appearance. Conclusions: Patients who underwent patellar resurfacing experienced anterior knee pain and satisfaction with the arthroplasty procedure that were equivalent to those experienced by patients whose patella was not resurfaced; however, these patients underwent significantly fewer additional surgical procedures. Further long-term follow-up of modern prostheses in randomized studies measuring outcome with a patella-specific score is needed.