Patellar resurfacing versus nonresurfacing in total knee arthroplasty: an updated meta-analysis of randomized controlled trials

Abstract

Background Whether resurface the patella or not in total knee arthroplasty (TKA) was controversial. In 2013, we conducted a meta-analysis of randomized controlled trials (RTCs). After that, plenty of studies have been carried out, but there still existed a great deal of controversy. In order to update our previous study, we conducted this update meta-analysis to evaluate the efficacy of patellar resurfacing in TKA. Methods Databases were searched for RCTs comparing the outcomes of patellar resurfacing and nonresurfacing in TKA. Outcomes of knee relevant indicators were analysed. To see the short- and long-term effects, we calculated the data in total and divided the patients who were followed up for ≤ 3 years and ≥ 5 years into two subgroups as well. Results Thirty-two trials assessing 6887 knees were eligible. There was a significant difference in terms of reoperation (in total and ≥ 5 years), Knee Society Score (KSS), function score (in total and ≥ 5 years) and noise. While no significant difference was found in the following items: reoperation (≤ 3 years), anterior knee pain (AKP), function score (≤ 3 years), range of motion (ROM), Oxford score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), visual analogue score (VAS), Feller score, patellar tilt and the patients’ satisfaction. Conclusions We found that patellar resurfacing could reduce the occurrence of reoperation and noise after surgery, as well as increase the KSS and function score, while it might not influence the outcomes such as AKP, ROM, Oxford score, KOOS, VAS, Feller score, patellar tilt and the patients’ satisfaction. The results are different from our previous finding in the meta-analysis. In conclusion, we prefer patellar resurfacing in TKA.

Influence of Psychological Distress in Patients with Hypoallergenic Total Knee Arthroplasty. Treatment Algorithm for Patients with Metal Allergy and Knee Osteoarthritis

“…The outcomes may be also influenced by the patella in those patients who had patellar resurfacing. Due to the small number of patients that had the patella prosthesis implanted (18%), we do not believe that this may had influenced the results, which is also supported by previous studies [ 37 , 38 ].…”

Influence of patellar denervation on anterior knee pain and knee function following total knee replacement: a systematic review and meta‐analysis

“…The occurrence of AKP was believed to be highly related to the patellofemoral joint, and theoretically, patella resurfacing was an important confounding factor of AKP occurrence following TKR. 33 To the best of our knowledge, all previous meta-analyses investigated the effect of PD in TKR with patella non-resurfacing and no subgroup analysis has been conducted to eliminate the influence of patella resurfacing on AKP occurrence. Two pioneer studies published in 2020 and 2021 investigated the PD in patella resurfacing TKR and were included in our study.…”

Factors Correlated With Physical Function 1 Year After Total Knee Arthroplasty in Patients With Knee Osteoarthritis

“…Evidence on factors associated with physical function has been reviewed previously, but findings were contradictory, limited in scope, based on pooled data across short-term and longer-term outcomes, or did not address certainty of evidence. 7 , 8 , 9 , 10 , 11 , 12 , 13 Thus, there is need for a new synthesis of evidence on short-term TKA outcomes that uses current systematic review methods and captures recently published studies. The aim of this systematic review and meta-analysis was to synthesize evidence on preoperative and intraoperative factors associated with physical function 12 months after TKA (primary outcome) and 3 and 6 months after TKA (secondary outcomes).…”