Native Patella Retention Versus Resurfacing in a Cohort of Staged Bilateral Total Knee Patients
Background: Patellar resurfacing in total knee arthroplasty remains a point of controversy within the literature and the generally followed paradigm varies among regions.
Methods: In effort to elucidate a difference following the change from universal patellar resurfacing to universal non-resurfacing, 32 patients with bilateral TKA that included one resurfaced and one native patella were retrospectively reviewed at average follow up 21.4 months from the most recent surgery.
Results: No difference was observed in patient satisfaction, KOOS-ADL score, and VAS scores. No complications or secondary patellar resurfacing occurred.
Conclusions: Therefore, patients perceive no difference between knees with native patella retention or a resurfaced patella in regards to pain and function.
Walldius B. Arthroplasty of the knee joint using endoprosthesis. Acta Orthop Scand Suppl 1957;24:1–112.
Schindler OS. The controversy of patellar resurfacing in total knee arthroplasty: Ibisne in medio tutissimus? Knee Surg Sports Traumatol Arthrosc 2013;20:1227–44.
Mochizuki RM, Schurman DJ. Patella complications following total knee arthroplasty. J Bone Jt Surg 1979;61A:879–83.
Insall JN, Lachiewicz PF, Burstein AH. The posterior stabilised prosthesis. A modification of the total condylar design. A two to four year clinical experience. J Bone Jt Surg 1982; 64A:1317–23.
Groeneveld HB.Total arthroplasty of the knee joint and the need for replacement of the patella. In: The medical engineering working party: total knee replacement. Mechanical Engineering Publications Limited, London, 1975 p.50–51.
Insall JN, Ranawat CS, Aglietti P, et al. A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am 1976;58(6):754.
Clayton ML, Thirupathi R. Patellar complications after total condylar arthroplasty. Clin Orthop. 1982;170:152-5.
Aglietti P, Buzzi R, Gaudenzi A. Patellofemoral functional results and complications with the posterior stabilized total condylar knee prosthesis. J Arthroplasty 1988;3:17-25.
Goldberg VM, Figgie HE 3rd, Inglis AE, Figgie MP, Sobel M, Kelly M, Kraay M. Patellar fracture type and prognosis in condylar total knee arthroplasty. Clin Orthop 1988;236:115-22.
Lombardi AV Jr, Engh GA, Volz RG, Albrigo JL, Brainard BJ. Fracture/dissociation of the polyethylene in metal-backed patellar components in total knee arthroplasty. J Bone Joint Surg Am. 1988;70:675-9.
Lynch AF, Rorabeck CH, Bourne RB. Extensor mechanism complications following total knee arthroplasty. J Arthroplasty. 1987;2:135-40.
Helmy N, Anglin C, Greidanus NV, Masri BA. To resurface or not to resurface the patella in total knee arthroplasty. Clin Orthop Relat Res 2008; 466 (11): 2775-83.
Clements WJ, Miller L, Whitehouse SL, Graves SE, Ryan P, Crawford RW. Early outcomes of patella resurfacing in total knee arthroplasty. Acta Orthop 2010; 81 (1): 108-13.
Murray DW, MacLennan GS, Breeman S, Dakin HA, Johnston L, Campbell MK, et al. A randomised controlled trial of the clinical effectiveness and cost-effectiveness of different knee prostheses: the Knee Arthroplasty Trial (KAT). Health Tech Ass 2014;18(19):1-235.
Chen K, Li G, Fu D, Yuan C, Zhang Q, Cai Z. Patellar resurfacing versus nonresurfacing in total knee arthroplasty: a meta-analysis of randomised controlled trials. Int Orthop 2013; 37 (6): 1075-83.
Pavlou G, Meyer C, Leonidou A, As-Sultany M, West R, Tsiridis E. Patellar resurfacing in total knee arthroplasty: does design matter? A meta-analysis of 7075 cases. J Bone Joint Surg Am 2011; 93 (14): 1301-9.
Pavlou G, Meyer C, Leonidou A, As-Sultany M, West R, Tsiridis E. Patellar resurfacing in total knee arthroplasty: does design matter? A meta-analysis of 7,075 cases. J Bone Jt Surg 2011;93-A:1301–1309.
Burnett RS, Boone JL, Rosenzweig SD, Steger-May K, Barrack R L. Patellar resurfacing compared with nonresurfacing in total knee arthroplasty. A concise follow-up of a randomized trial. J Bone Joint Surg Am 2009; 91(11):2562-7.
Breeman S, Campbell M, Dakin H, Fiddian N, Fitzpatrick R, Grant A, et al. Patellar resurfacing in total knee replacement: five-year clinical and economic results of a large randomized controlled trial. J Bone Joint Surg Am 2011;93(16):1473-81.
Group KATT, Johnston L, MacLennan G, McCormack K, Ramsay C, Walker A. The Knee Arthroplasty Trial (KAT) design features, baseline characteristics, and two-year functional outcomes after alternative approaches to knee replacement. J Bone Joint Surg Am 2009; 91 (1): 134-41.
Ogon M, Hartig F, Bach C, Nogler M, Steingruber I, Biedermann R. Patella resurfacing: no benefit for the long-term outcome of total knee arthroplasty. A 10- to 16.3-year follow-up. Arch Orthop Trauma Surg 2002;122(4):229-34.
Abdel MP. Parratte S, and Budhiparama NC. The Patella in Total Knee Arthroplasty: To Resurface or Not Is the Question. Current Reviews in Musculoskeletal Medicine 2014;7.2: 117-24.
Figgie HE III, Goldberg VM, Heiple KG, Moller HS III, Gordon NH. The influence of tibial-patellofemoral location on function of the knee in patients with the posterior stabilized condylar knee prosthesis. J Bone Jt Surg 1986;68:1035–40.
Robertsson O, Dunbar M, Phersson T, Knutson K, Lidgren L (2000) Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand 2000;71:262–7.
Roberts DW, Hayes TD, Tate CT, Lesko JP. Selective Patellar Resurfacing in Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind Study. J Arthroplasty 2015;30:216–22.
Waters TS, Bentley G. Patellar Resurfacing in Total Knee Arthroplasty. J Bone Joint Surg. Am. 2003;85(2) 212-17.
Mockford BJ, Beverland DE. Secondary resurfacing of the patella in mobile-bearing total knee arthroplasty. J Arthroplasty 2005;20:898–902.
Barrack RL, Bertot AJ, Wolfe MW, Waldman DA, Milicic M, Myers L. Patellar resurfacing in total knee arthroplasty: A prospective randomised double blinded study with five to seven years of follow-up. J Bone Jt Surg 2001;83-A:1376–81.
Kwon OS, Bae DK. Comparative Analysis of Resurfaced and Unresurfaced Patella in Bilateral Total Knee Arthroplasty. J of Korean Northrop Assoc. 2003;38:478-483
Keblish PA, Varma AK, Greenwald AS. Patellar resurfacing or retention in total knee arthroplasty. A prospective study of patients with bilateral replacements. Bone & Joint Journal 1994;76-B(6)930-93
Burnett RS, Boone JL, McCarthy KP, Rosenzweig SD, Barrack RL. A prospective randomised clinical trial of patellar resurfacing and nonresurfacing in bilateral TKA. Clin Orthop Relat Res 2007;464:65–72.
Berger RA, Crossett LS, Jacobs JJ, Rubash HE. Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res 1998;356:144–53.
Incavo SJ, Wild JJ, Coughlin KM, Beynnon BD. Early revision for component malrotation in total knee arthroplasty. Clin Orthop Relat Res 2007;458:131–136.
Incavo SJ, Coughlin KM, Pappas C, Beynnon BD. Anatomic rotational relationship of the proximal tibia, distal femur, and patella. J Arthroplasty 2003;18:643–648.
Liu ZT, Fu PL, Wu HS, Zhu Y. Patellar reshaping versus resurfacing in total knee arthroplasty—results of a randomized prospective trial at a minimum of 7 years’ follow-up. Knee. 2012 Jun;19(3):198-202.
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