Total Knee Arthroplasty Without Patellar Resurfacing / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To Analyze the Clinical Results of the Total Knee Arthroplasty without Patellar Resurfacing. MATERIALS AND METHODS: One hundred and eight Total Knee Arthroplasties (Nexgen(R), Zimmer, USA) without resurfacing of the patella, were performed between February 1995 and September 1999, and 89 cases followed up for more than 36 months were analyzed in this study. The follow up period ranged from 36 to 70 months (average 52 months). The diagnosis was degenerative joint disease in 83 cases (93%), rheumatoid arthritis in 5 cases (6%) and avascular necrosis of medial femoral condyle in 1 case (1%). The clinical results were evaluated according to Knee Society Clinical Rating System. RESULTS: The mean preoperative knee score was 34 points (range 5-63 points) according to the Knee Society Clinical Rating System, and the mean preoperative functional score was 38 points (range, 10-61 points). The mean postoperative knee score was 91 points (range 65-98 points) and the mean postoperative functional score 89 points (range, 63-100 points). The current study shows that patellar complications associated with unresurfacing did not occur, with the exception of 2 cases of persistent peripatellar pain, which resolved by a postoperative 6 months with conservative treatment. The patellofemoral joint space was also well preserved even at the 3 and 5 year follow-ups. CONCLUSION: Complications of total knee arthroplasty, such as patellar dislocation or subluxation, rupture of the patellar tendon, and fracture of the patella, can be avoided by not resurfacing the patella. On the basis of our results, there is little evidence to support routine patellar resurfacing in total knee arthroplasty.