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 Adult Knee Reconstruction Test 2: Primary Total Knee Arthroplasty
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The Journal of Bone and Joint Surgery (American) 85:728-745 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

Indications for Patellar Resurfacing in Total Knee Arthroplasty

R. Stephen Burnett, MD and Robert B. Bourne, MD

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

R. Stephen Burnett, MD
Robert B. Bourne, MD
Division of Orthopaedic Surgery, London Health Sciences Centre, University Campus, London, ON N6A 5A5, Canada. E-mail address for R.B. Bourne: robert.bourne@lhsc.on.ca

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive 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.

Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in March 2004 in Instructional Course Lectures , Volume 53. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).

The first 150 words of the full text of this article appear below.


   Introduction
 
The controversy about whether to resurface the patella or to leave the native patella unresurfaced continues to be debated by orthopaedic surgeons performing total knee arthroplasties 1 . When the original total knee prostheses were designed, the patellofemoral articulation was not taken into consideration as a potential source of pain, and the results were complicated by patellofemoral symptoms despite an otherwise well-performed knee arthroplasty. Subsequent designs incorporated a femoral flange for the patellofemoral articulation and provided the option for patellar resurfacing. These early implants were not designed to accommodate the native patella in an anatomic fashion during the range of motion, and resurfacing of the patella was recommended. Complications related to patellar resurfacing became a primary concern, however, and have been associated with the variable revision rates often reported after total knee arthroplasty. Subsequent modifications in implant design have been made to offer the surgeon the option of . . . [Full Text of this Article]


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