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The Journal of Bone and Joint Surgery, Vol 75, Issue 5 674-681, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
Long-term complications after total knee arthroplasty with or without resurfacing of the patella
AD Boyd, FC Ewald, WH Thomas, R Poss and CB Sledge
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115.
The long-term complications related to the patella were retrospectively
evaluated for 891 knees (684 patients) that had had a total arthroplasty,
with or without resurfacing of the patella, with use of an unconstrained,
condylar, posterior-cruciate-preserving prosthesis. The study population
comprised two groups of patients who were similar in size, age, sex
distribution, and diagnosis. One group (396 knees [303 patients]) had had a
total knee arthroplasty with patellar resurfacing and the other group (495
knees [381 patients]) had had the same procedure without resurfacing. The
average duration of follow-up was six and one-half years (range, two to
fifteen years). The decision to resurface the patella was based on
subjective inspection of the articular surface and on assessment of
patellar tracking at the time of the operation. Resurfacing was performed
if there was loss of cartilage, exposed bone, gross surface irregularities,
or tracking abnormalities. Complications occurred an average of three years
(range, immediately postoperatively to nine years) after the operation in
the group that had had resurfacing and an average of four years (range,
immediately post-operatively to ten years) postoperatively in the group
that had not had resurfacing. In the group that had had resurfacing, there
was loosening of the patellar component in five knees, patellar subluxation
in four knees, fracture of the patella in three knees, rupture of the
patellar tendon in three knees, and chronic peripatellar pain in one knee.
In the group that had not had resurfacing, the complications included
patellar subluxation in five knees, rupture of the patellar tendon in two
knees, and chronic peripatellar pain in fifty-one knees.(ABSTRACT TRUNCATED
AT 250 WORDS)
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