The Journal of Bone and Joint Surgery (American) 84:187-193 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.
Patellar Resurfacing in Total Knee Arthroplasty
A Prospective, Randomized Trial
David J. Wood, MS, FRCS,
Anne J. Smith, BAppSc,
Dermot Collopy, MBBS, FRACS(Orth),
Bruce White, MBBS, FRACS(Orth),
Boris Brankov, MDBA and
Max K. Bulsara, BSc(Hons), MSc(Kent)
Investigation performed at the Division of Orthopaedics, Department
of Surgery, University of Western Australia, Nedlands, Western Australia,
Australia
David J. Wood, MS, FRCS
Anne J. Smith, BAppSc
Dermot Collopy, MBBS, FRACS(Orth)
Bruce White, MBBS, FRACS(Orth)
Boris Brankov, MD, BA
Division of Orthopaedics, Department of Surgery, University of
Western Australia, 2nd Floor, M Block, QEII Medical Centre, Nedlands
6009, Western Australia, Australia. E-mail address for D.J. Wood:
dwood{at}cyllene.uwa.edu.au
Max K. Bulsara, BSc(Hons), MSc(Kent)
Department of Public Health Biostatistical Consulting Service,
University of Western Australia, 1st Floor, Clifton Street Building,
Nedlands Campus, Nedlands 6009, Western Australia, Australia
In support of their research or preparation of this manuscript, one
or more of the authors received grants or outside funding from Zimmer.
None of the authors received payments or other benefits or a commitment
or agreement to provide such benefits from a commercial entity.
No commercial entity paid or directed, or agreed to pay or direct,
any benefits to any research fund, foundation, educational institution,
or other charitable or nonprofit organization with which the authors are
affiliated or associated.
Background: The management of the patella in
total knee arthroplasty is still problematic. We aimed to identify
differences in the clinical outcome of total knee arthroplasty according
to whether or not patellar resurfacing had been performed in a prospective,
randomized study of 220 osteoarthritic knees.
Methods: Two hundred and twenty total knee arthroplasties
in 201 patients were randomly assigned to be performed with either resurfacing
or retention of the patella, and the results were followed for a
mean of forty-eight months (range, thirty-six to seventy-nine months)
in a double-blind (both patient and clinical evaluator blinded),
prospective study. Evaluation was performed annually by an independent
observer and consisted of assessment with the Knee Society clinical
rating system, specific evaluation of anterior knee pain, a stair-climbing
test, and radiographic examination.
Results: Fifteen (12%) of the 128 knees
without patellar resurfacing and nine (10%) of the ninety-two
knees with patellar resurfacing underwent a revision or another
type of reoperation related to the patellofemoral articulation.
This difference was not significant (chi square with one degree
of freedom = 0.206, p = 0.650). At the time of
the latest follow-up, there was a significantly higher incidence
of anterior pain (chi square with one degree of freedom = 5.757,
p = 0.016) in the knees that had not had patellar resurfacing.
Conclusions: Patients who underwent patellar resurfacing
had superior clinical results in terms of anterior knee pain and
stair descent. However, anterior knee pain still occurred in patients with
patellar resurfacing, and nine (10%) of the ninety-two patients
in that group underwent a revision or another type of reoperation
involving the patellofemoral joint. Weight but not body mass index
was associated with the development of anterior knee pain in the
patients without patellar resurfacing, a finding that suggests that
patellofemoral dysfunction may be a function of joint loading rather
than obesity.
 CiteULike  Connotea  Del.icio.us  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
I. Han, C. B. Chang, S. Lee, M. C. Lee, S. C. Seong, and T. K. Kim
Correlation of the condition of the patellar articular cartilage and patellofemoral symptoms and function in osteoarthritic patients undergoing total knee arthroplasty
J Bone Joint Surg Br,
August 1, 2005;
87-B(8):
1081 - 1084.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. E. Pakos, E. E. Ntzani, and T. A. Trikalinos
Patellar Resurfacing in Total Knee Arthroplasty. A Meta-Analysis
J. Bone Joint Surg. Am.,
July 1, 2005;
87(7):
1438 - 1445.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Rand
Extensor Mechanism Complications Following Total Knee Arthroplasty
J. Bone Joint Surg. Am.,
September 1, 2004;
86(9):
2062 - 2072.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H.-N. Shih, L.-Y. Shih, Y.-C. Wong, and R. W.-W. Hsu
Long-Term Changes of the Nonresurfaced Patella After Total Knee Arthroplasty
J. Bone Joint Surg. Am.,
May 1, 2004;
86(5):
935 - 939.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. S. Burnett and R. B. Bourne
Indications for Patellar Resurfacing in Total Knee Arthroplasty
J. Bone Joint Surg. Am.,
March 31, 2003;
85(4):
728 - 745.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. G. Rosenberg, J. J. Jacobs, K. J. Saleh, R. A. Kassim, M. J. Christie, D. G. Lewallen, J. A. Rand, and H. E. Rubash
The Patella in Revision Total Knee Arthroplasty
J. Bone Joint Surg. Am.,
January 21, 2003;
85(90001):
S63 - 70.
[Full Text]
[PDF]
|
|
|
|
