The Journal of Bone and Joint Surgery, Vol 77, Issue 9 1323-1330, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Primary total knee arthroplasty after patellectomy
SD Martin, SB Haas and JN Insall
Knee Service, New York Hospital--Cornell University Medical Center, New York City, USA.
The results of twenty-two consecutive primary total knee replacements,
performed an average of nine years (range, one to twenty-three years) after
a patellectomy in twenty-two patients, were reviewed retrospectively. The
average duration of follow-up was seven years (range, three to fifteen
years). The average age of the patients at the time of the arthroplasty was
sixty-seven years (range, thirty-six to eighty-nine years). The average
Hospital for Special Surgery knee score was 46 points (range, 22 to 74
points) preoperatively and 76 points (range, 45 to 97 points)
postoperatively. Thirteen patients had an excellent or good result and
seven had a fair or poor result; in two patients, the operation was
considered a failure. Except for one patient who had myasthenia gravis, all
patients could climb stairs in reciprocal manner. Four patients lacked 5 to
20 degrees of active extension compared with passive extension. With
respect to the over-all results, there was no significant difference among
the four types of prostheses that were used (p = 0.2). The patients who had
received an Insall-Burstein posterior stabilized prosthesis had better
scores for pain and function than did the patients who had received a total
condylar I prosthesis (p = 0.005 and 0.01, respectively). There was a
direct correlation between the knee score and the number of years that had
elapsed since the patellectomy. The longer the interval between the
patellectomy and the total knee replacement, the higher the postoperative
knee score (r = 0.78, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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