Patients undergoing total knee arthroplasty using a contemporary patella-friendly implant are unaware of any differences due to patellar resurfacing.

Koh, In Jun; Kim, Man Soo; Sohn, Sueen; Song, Kwang Yun; Choi, Nam Yong; In, Yong

<bold>Purpose: </bold>Anterior knee pain after total knee arthroplasty (TKA) is often unexplained, spurring ongoing debates on the need for patellar resurfacing. It was hypothesized that a contemporary patella-friendly implant would restore patellofemoral kinematics more physiologically than outdated implants and that there would be no perceived or clinically demonstrable differences due to resurfacing of patella (RP).<bold>Methods: </bold>This prospective bilateral randomized study was undertaken in 49 patients scheduled for the same-day bilateral TKAs. One knee was subjected at random to RP while withholding RP on the opposing side (non-RP). A recently approved single-radius femoral prosthesis featuring a deep, elongate trochlear groove with lateral tilt and a high lateral flange was implanted bilaterally in all patients. Mean follow-up duration was 5 years. Group comparisons were based on patient-reported outcomes [anterior knee pain, Forgotten Joint Score (FJS), and side preference], physician-rated results [Feller patellofemoral (PF) score], radiographic patellar position, patella-related complications, and need for reoperation.<bold>Results: </bold>There were no differences in midterm rates of anterior knee pain (RP 8%; non-RP 4%; n.s.), FJS (all n.s.), or side preference (RP 47%; non-RP 45%; n.s.), nor did the groups differ by Feller PF score (all n.s.) or radiographic patellar position (all n.s.). No secondary resurfacings of non-RP or RP revisions were required.<bold>Conclusions: </bold>Patients were incapable of distinguishing whether RP was done, casting doubt on its benefits. Surgeons may thus forego RP during TKA when using contemporary patella-friendly TKA implants.<bold>Level Of Evidence: </bold>Therapeutic study, Level I.

TOTAL knee replacement; ARTHROPLASTY; PATELLA; MEDICAL care; KNEE pain; FEMUR surgery; KNEE surgery; ARTIFICIAL joints; COMPARATIVE studies; KINEMATICS; KNEE diseases; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; OSTEOARTHRITIS; SENSORY perception; PROSTHETICS; REOPERATION; RESEARCH; RESEARCH evaluation; TIME; EVALUATION research; PAIN measurement; RANDOMIZED controlled trials; TREATMENT effectiveness; DISEASE prevalence

Knee Surgery, Sports Traumatology, Arthroscopy, 2019, Vol 27, Issue 4, p1156

0942-2056

Academic Journal

10.1007/s00167-018-5120-2