Patellar Nonresurfacing in Total Knee Arthroplasty

ABSTRACT

PURPOSE: The management of the patella in total knee arthroplasty is still controversy. The purpose of this study was to evaluate clinical and radiological results after total knee arthroplasty without patellar resurfacing. MATERIALS AND METHODS: We retrospective evaluated the nonresurfaced patella in 50 Knees(45 patients) at an average of 65.5 months after total knee arthroplasty(Duracon (R), Howmedica, Rutherford, NJ). Patients were diagnosed as osteoarthritis in 45 and rheumatoid arthritis in 3 and the others were osteonecrosis and evaluated using the knee society knee score, functional knee score and modified patellar score. RESULTS: The mean preoperative knee society knee score in osteoarthritis and rheumatoid arthritis were 58.2 and 36.7 points, and functional score were 35.8 and 34 points. The mean postoperative knee society knee score in osteoarthritis and rheumatoid arthritis were 94.5 and 91.2 points, and functional score were 73.2 and 81 points and the mean modified patellar score was 28.5 points, and 26 cases(52%) were excellent(30-35 points), 18 cases(36%) were good(25-29 points) and 6 cases(12%) were fair(20-24 points). There were no patella-associated complications and in 8 cases(16%) of anterior knee pain, which resolved by a postoperative 4.1 months with conservative treatment. CONCLUSION: Total knee arthroplasty with patelloplasty, without patellar resurfacing , provided satisfactory results without significant problems, and can avoid the patellar complications. But long term radiological and clinical follow-up is recommended.