To resurface or not to resurface the patella? A long term study

Abstract

Introduction: Despite the widespread use of total knee replacement, whether to resurface or not resurface patella remains a subject of great controversy. This study aimed to examine the long-term results of total knee replacement with and without patella resurfacing using a single type of prosthesis. Methodology: n/a. Results and Analysis: 285 total knee replacements were performed in our centre from 2000-2002. 64.3% of the patella in these replacements were not resurfaced and 35.7% were resurfaced at the time of replacement. After excluding those that were lost to follow up, 223 patients were available for analysis. 84.8% were female. Average age at operation was 64.6+/-9.6 years. Average duration of follow up was 14.6+/-3.2 years. 30 patients (13.5%) of patients required revision procedures, performed at an average of 6.8 years post-operation. No patients underwent revision for secondary patella resurfacing. Reasons for revision include aseptic loosening (86.7%), bearing spin-out (6.7%), infection (3.3%) and heterotopic ossification (3.3%). Incidence of residual knee pain was higher in the resurfaced group (9.6%) compared to that in the non-resurfaced group (6.25%). Discussion and Conclusion: The results of this study suggest that the incidence of knee pain after knee arthroplasty without patella resurfacing in the long term in general is low. Interestingly, patella resurfacing resulted in a higher incidence of residual knee pain compared to non-resurfaced patients. Most importantly, revision due to patella resurfacing was not needed for our patient cohort which brings into question whether patella resurfacing indeed is needed for a successful knee replacement.