Does patellar resurfacing decrease incidence of patellar crepitus after Total Knee Arthroplasty - patellar resurfacing versus non-resurfacing

Abstract

Introduction: Patella crepitus is not uncommon after total knee arthroplasty (TKA). Previous studies showed that it is associated with an increase in contact pressure at patellofemoral joint in posterior stabilised TKA. This study aimed to examine whether patella resurfacing is associated with an increase in the incidence of patella crepitus in a single design of TKA. Materials and Methods: Patients receiving TKA using NexGen LPS-Flex design were included. The demographic data, presence of patella crepitus and associated activities, presence of anterior knee pain, Knee Society Knee Score (KSKS), and Knee Society Function Score (KSFA) were collected. The association of patella resurfacing and patella crepitus was also assessed. Results: A total of 40 patients with 45 TKAs were included. The mean age at operation was 69 (range, 51-82) years. Patella resurfacing was performed in 17 knees while patella non-resurfacing was in 28 knees. The latest KSKS, KSFA, and maximum knee flexion did not differ between 2 groups. Patella crepitus was present in 28.9% (13/45) of TKAs. There was no association between patella resurfacing and patella crepitus. In the presence of patella crepitus, 31% (4/13) complained of anterior knee pain while 28% (9/32) of those without patella crepitus complained of anterior knee pain. Discussion and Conclusion: Patella crepitus is not an uncommon phenomenon after TKA. Whether resurfacing patella or not does not decrease its incidence. The presence of patella crepitus after TKA is not associated with an increase in the incidence of anterior knee pain.