The Journal of Bone and Joint Surgery, Vol 72, Issue 9 1379-1382, Copyright © 1990 by Journal of Bone and Joint Surgery, Inc
The patellofemoral joint after total knee arthroplasty without patellar resurfacing
GD Picetti, WA McGann and RB Welch
San Francisco Orthopaedic Residency Training Program, Saint Mary's Hospital and Medical Center, California 94117.
One hundred total knee replacements with a total condylar prosthesis and
without patellar resurfacing were followed for a minimum of two years.
Eighty-four per cent of the knees were affected by osteoarthrosis. Graded
according to the knee-rating system of the Hospital for Special Surgery,
there were eighteen excellent, fifty-three good, eighteen fair, and eleven
poor results. At the most recent follow-up, twenty-nine knees (29 per
cent), nine of which were affected by rheumatoid arthritis, were still
painful in the patellofemoral area. The height and weight of the patient
definitely influenced the amount of patellofemoral pain postoperatively.
Small patients who had osteoarthrosis were exceptionally free of pain,
regardless of sex, age, or level of activity. It seems that the best
approach to patellofemoral replacement includes resurfacing of the patella
in all patients who have rheumatoid arthritis and in patients who have
osteoarthrosis if they have preoperative patellofemoral pain, are more than
160 centimeters tall, weigh more than sixty kilograms, and have advanced
changes in the patella at the time of the operation.
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