Selective Patellar Resurfacing in Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind Study

Native Patella Retention Versus Resurfacing in a Cohort of Staged Bilateral Total Knee Patients

“…The authors concluded that the clinical significance of this outcome may be minimal. [25] Liu, et al found similar results in their 133 patients randomized to receive either resurfacing with the modified dome implant or patellar reshaping; which included: resecting the partial lateral facet of the patella and the osteophytes surrounding the patella, trimming the patella to match the trochlea of the femoral component. They found no significant difference between the groups with regard to the Knee Society Scores, presence of anterior knee pain rate and radiographic differences.…”

“…[17] While we found no difference in VAS scores between resurfaced and unresurfaced sides, numerous reports exist in the literature of a higher revision rate for TKA with unresurfaced patella related to anterior knee pain (AKP). [18,25] In a prospective, randomized study of 514 consecutive primary press-fit condylar total knee replacements, Waters and Bentley found an increased prevalence of anterior knee pain in the unresurfaced patellae cohort, 25.1%, compared to 3.5% in the resurfaced group. [26] Of note, 35 patients in their cohort had simultaneous bilateral TKA with one resurfaced and one unresurfaced patella.…”

Understanding the patellofemoral joint in total knee arthroplasty

“…15 Furthermore, the relative ease of application, reduced risk of malalignment and excellent track record make the all-polyethylene dome-shaped patella a popular choice. 16 Although failure of the all-polyethylene patellar components is rare, identified risk factors for failure are increased body weight, high preoperative flexion, retinacular release, weakness of the pegs of the component and avascular necrosis of the patella. 17…”

Resurfaced versus Non-Resurfaced Patella in Total Knee Arthroplasty

“…Early comparative studies looked at outcomes of TKA with and without patella resurfacing, with widely varying results. While some studies supported routine patellar resurfacing based upon functional scores and patient satisfaction, [8][9][10][11][12][13] many had contradicting evidence supporting never resurfacing or selective resurfacing. Within the past 20 years, level 1 studies have supported selective or no patellar resurfacing as results have yielded no significant differences between the two procedures.…”

“…Numerous studies have not found significant differences between groups treated with or without resurfacing with regard to Knee Society Score (KSS), pain scores, functional scores, or radiological outcomes, and support never or selective resurfacing of the patella. 13,[23][24][25][26][27][28][29][30][31][32][33][34][35][36] Barrack et al studied 118 randomized TKA and found that anterior knee pain, a theoretical concern of nonpatella resurfacing critics, is related to prosthetic design or surgical technique rather than whether the patella is resurfaced or not. 23 In a randomized controlled trial of 100 TKA, Mayman et al found similar functional results between resurfacing and non-resurfacing groups, but when it came to anterior knee pain, they found significantly decreased reports of knee pain in the resurfaced group.…”