DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20183677

A prospective study to review the functional outcome between patellofemoral resurfacing versus non resurfacing in total knee replacement

Sharat Balemane, Arshad Attar, Aaron Ruben Dsouza

Abstract


Background: A prospective study to review the functional outcome between patellofemoral resurfacing versus non resurfacing in posterior stabilized TKR.

Methods: We studied a total of 63 patients with tricompartmental osteoarthritis of knee. These patients underwent total knee arthroplasty between April 2013 to September 2013 at Preethi hospital, Madurai. It was prospective study which was followed up for period of 1 year. There were two groups which were made randomly into patellofemoral resurfacing group (group A n=30) and the non resurfacing group (group B n=33). In the patellofemoral resurfacing group, patella was resurfaced with the help of cemented poly component and in the non-resurfacing group, the osteophytes of the patella was removed, it was reshaped to match the trochlea of the femoral prosthesis and circumpatellar denervation was done. Knee society score (KSS), anterior knee pain, knee society function score and patient satisfaction was compared between both the groups.

Results: There was significant difference in anterior knee pain scale and incidence of anterior knee pain was less as compared in the resurfacing group. However 1 year of follow up of both groups concluded that there was no significant differences for functional outcomes. Patient satisfaction scale was significant in patellofemoral resurfacing group.

Conclusions: Study showed that apart from significant improvement in anterior knee pain scale there was no significant difference for both groups after 1 year follow up in clinical outcome, except for patient satisfaction scale. For patellofemoral pain and severe patellofemoral arthritis it is recommended to perform patellar resurfacing, otherwise patellar resurfacing do not have any added advantage.


Keywords


Patellofemoral resurfacing, Patellar non resurfacing, Anterior knee pain, Total knee arthoplasty

Full Text:

PDF

References


Robert L, Barrack MD, Alexander j et al :Patellar resurfacing in total knee arthroplasty, a prospective randomized, double-blind study with five to seven years of follow up. J Bone Joint Surg. 2001;83(9):1376-81.

Bourne RB, Stephen R, Burnett J. The consequences of Not Resurfacing the patella. Clin Orthop Related Res. 2004;428:166-9.

Waters TS, Bentley G. Patellar resurfacing in total knee arthroplasty. A prospective, randomized study. J Bone Joint Surg Am. 2003;85:212-7.

Keblish P, Varma A, Greenwald S. Patellar resurfacing or retention in total knee arthroplasty, a prospective study of patients with bilateral replacements. J Bone Joint Surg. 1994;76:930-7.

Dennis DA. Extensor mechanism problems in total knee arthroplasty. Instr Course Lect. 1997;46:171 – 80.

Whiteside LA, Nakamura T. Effect of femoral component design on unresurfacedpatellas in knee arthroplasty. Clin Orthop Relat Res. 2003;410:189 – 98.

Feller JA, Bartlett RJ, Lang DM. Patellar resurfacing versus retention in total knee arthroplasty. J Bone Joint Surg [Br]. 1996;78:226-8.

Tabutin J, Banon F, Catonne Y, et al: Should we resurface the patella in total knee replacement? Experience with the Nex Gen prothesis. Knee Surg Sports Traumatol Arthrosc. 2005;13:534-8.

Whiteside LA, Nakamura T. Effect of femoral component design on unresurfacedpatellas in knee arthroplasty. Clin Orthop Relat Res. 2003;410:189–98.

Liu HC. Review of gross anatomy of the Chinese knee. Taiwan Yi XueHuiZaZhi. 1984;83:317-25.

Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the knee society clinical rating system. Clin Orthop Relat Res. 1989;248:13-4.