The Journal of Bone and Joint Surgery (American). 2009;91:2562-2567.
doi:10.2106/JBJS.H.00109
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Patellar Resurfacing Compared with Nonresurfacing in Total Knee Arthroplasty

A Concise Follow-up of a Randomized Trial*

R. Stephen J. Burnett, MD, FRCS(C)1, Julienne L. Boone, MD2, Seth D. Rosenzweig, MD3, Karen Steger-May, MA4 and Robert L. Barrack, MD2

1 Division of Orthopaedic Surgery, Vancouver Island Health-South Island, Royal Jubilee Hospital, 1952 Bay Street, Victoria, BC V8R 1J8 Canada. E-mail address: stephen.burnett{at}viha.ca
2 Department of Orthopaedic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, Campus Box 8233, 660 South Euclid Avenue, St. Louis, MO 63110
3 Dauterive Orthopaedics and Sports Medicine, 500 North Lewis, Suite 280, New Iberia, LA 70563
4 Division of Biostatistics, Washington University, Campus Box 8067, 660 South Euclid Avenue, St. Louis, MO 63110

Investigation performed at the Department of Orthopaedic Surgery, Tulane University, New Orleans, Louisiana, and the Department of Orthopaedic Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St. Louis, Missouri

* Original Publications

Barrack RL, Wolfe MW, Waldman DA, Milicic M, Bertot AJ, Myers L. Resurfacing of the patella in total knee arthroplasty. A prospective, randomized, double-blind study. J Bone Joint Surg Am. 1997;79:1121-31.

Barrack RL, Bertot AJ, Wolfe MW, Waldman DA, Milicic M, Myers L. Patellar resurfacing in total knee arthroplasty. A prospective, randomized, double-blind study with five to seven years of follow-up. J Bone Joint Surg Am. 2001;83:1376-81.

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families 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, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Patellar resurfacing in total knee arthroplasty remains controversial. This study compared the long-term clinical outcomes of total knee arthroplasties performed with and without the patella resurfaced and is an update of a previous report. Eighty-six patients (118 knees) underwent primary total knee replacement and were randomized into two groups: those treated with and those treated without resurfacing of the patella. Outcomes included the scores according to the Knee Society clinical rating system, the scores according to a forty-one-question patellofemoral-specific patient questionnaire, patient satisfaction, global and anterior knee pain scores, radiographic findings, and complications and revisions. Fifty-seven patients (seventy-eight knees) were followed for a minimum of ten years. No significant differences were identified between the two groups in terms of the range of motion, Knee Society scores, satisfaction, global knee pain, or anterior knee pain. The overall revision rates in the original series of 118 knees were 12% in the nonresurfacing group and 9% in the resurfacing group. Seven patients (12%) in the nonresurfacing group and two patients (3%) in the resurfacing group underwent revision for a reason related to a patellofemoral problem. On the basis of these findings, we concluded that, with the type of total knee arthroplasty used in our patients, similar results may be achieved with and without patellar resurfacing.

Level of Evidence: Therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence.


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