Patellar pain after total knee arthroplasty comparison of the results of total knee arthroplasty with and without resurfacing of the patella

ABSTRACT

This study included 43 patients with 56 knees in whom the patella was not severely deformed and whom had primary total knee arthroplasty [TKA] for osteoarthritis of the knee, the operation was done by the same team of surgeons using; one type of prothesis [PFC]. The study and follow-up of the patients was done through years 2000-2004, at Barah a Hospital UAR. The patients were randomly allocated either to have the patella retained [36 knees] or resurfaced with a cemented, all polyethelyne component regardless of the state of the patellar articular cartilage [20 knees]. Apart from removal of osteophytes, patelloplasty was done on the retained patellae. The aim of the study was to compare the clinical results with total knee arthroplasty with patellar resurfacing and those after total knee arthroplasty with retension of the patella. The patients were followed for 3 years [mean, 38 months], and the postoperative status of the patients was evaluated with use of the clinical scoring system of the knee society, a patient satisfaction questionnaire, specific questions regarding patello-femoral symptoms and function, and radiograph findings. Preoperatively, the mean Knee Society Score, on a scale ranging from 0 to 100 points, was a mean of 47.6 [range, 45.0 to 49.7 points]; postoperatively, this score improved to a mean of 81.6 points [range, 56.6-93.9 points]. With the number available for the study we could detect a significant difference between the knees that had patellar resurfacing with the mean of 91.6 points [range, 89.5 to 93.9 points]; and those without with the mean of 70.7 points [range, 56.1 to 65.7 points]. Eight [22.2%] of the 36 knees with retained patella had anterior knee pain compared with 1 knee [5%] of the 20 knees with resurfaced patella; this was a significant difference [P<0.05]. The findings suggest that, in order to diminish pain on the patellofemoral joint, replacement of the patella during total arthroplasty is preferable