Background: Total knee arthroplasty (TKA) has become the main surgical tool in the treatment of primary osteoarthritis of the knee. Outcomes appear to be similar both clinically and functionally, with or without patellar resurfacing.
Purpose: Patellar resurfacing during prosthetic replacement
of the knee is associated with loosening and the need for secondary revision.
In many cases, the patella is left unreplaced during this procedure in order to
decrease the revision risk. Some of these patients remain symptomatic after
knee replacement. Secondary isolated resurfacing of the previously unresurfaced
patella in total knee arthroplasty remains controversial. The aim of this
retrospective study was to evaluate the outcome after isolated patellar
resurfacing (IPR) as a second-stage procedure.
Methods: The study included 33 patients (22 females/11
males) who underwent resurfacing of the patella with a mean follow-up of 44.8 ±
12.2 months. The mean age of the patients was 70.3 ± 15 (range 39–95) years at
the time of operation. The average period between total knee arthroplasty and
patellar resurfacing was 23.3 ± 15.2 months. The patient’s subjective
satisfaction was assessed according to the Knee Society Score (KSS)
questionnaire.
Results: The mean objective KSS improved significantly from
41.6 ± 9 to 64.9 ± 11 (P < .01). The mean functional KSS also improved
significantly from 41.6 ± 8 to 60.5 ± 9 (P < .01). Two patients (6%) needed
further operative revision. Multivariate analysis indicates that results are
better in males and in non-obese patients.
Conclusions. Although clinical scores showed significant
improvement, some patients have pain and remain dissatisfied following IPR. IPR
should be considered in patients who underwent prosthetic knee bicompartmental.
Patellar resurfacing should be considered if there is no evidence of prosthetic
component malalignment and at least 12 months have passed since the primary
implantation. Some patients are likely to suffer from AKP after knee
arthroplasty. In persistent AKP, IPR should be performed provided there is no
component malalignment per computerized tomography, no evidence of infection
and preferably in a nonobese patient.
Author (s) Details
Mustafa Yassin
Department of Orthopedic Surgery, Hasharon Hospital, Rabin Medical Center,
Petah Tikva, Affiliated with the Sackler School of Medicine, Tel Aviv
University, Tel Aviv, Israel.
Avraham Garti
Department of Orthopedic Surgery, Hasharon Hospital, Rabin Medical Center,
Petah Tikva, Affiliated with the Sackler School of Medicine, Tel Aviv
University, Tel Aviv, Israel.
Moshe Weissbrot
Department of Orthopedic Surgery, Hasharon Hospital, Rabin Medical Center,
Petah Tikva, Affiliated with the Sackler School of Medicine, Tel Aviv
University, Tel Aviv, Israel.
Uzi Ashkenazi
Department of Orthopedic Surgery, Hasharon Hospital, Rabin Medical Center,
Petah Tikva, Affiliated with the Sackler School of Medicine, Tel Aviv
University, Tel Aviv, Israel.
Muhammed Khatib
Department of Orthopedic Surgery, Hasharon Hospital, Rabin Medical Center,
Petah Tikva, Affiliated with the Sackler School of Medicine, Tel Aviv
University, Tel Aviv, Israel.
Dror Robinson
Department of Orthopedic Surgery, Hasharon Hospital, Rabin Medical Center,
Petah Tikva, Affiliated with the Sackler School of Medicine, Tel Aviv
University, Tel Aviv, Israel.
Please see the book here:-
https://doi.org/10.9734/bpi/msti/v3/3956
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