Comparison of outcomes between resurfaced and unresurfaced patella in total knee arthroplasty using medial congruent liners: A retrospective study

Abstract

Introduction

Total knee replacements are becoming more prevalent. There is still a lot of controversy regarding patellar resurfacing. Surgeons advocating for resurfacing state reduced risk for anterior knee pain and need for future revision surgery. Our goal was to determine if patients would have similar outcomes if the patella is left unresurfaced or resurfaced with a medial congruent liner design.

Patients and methods

A multi-surgeon retrospective chart review was conducted in a tertiary academic center, to identify all patients who received a total knee arthroplasty utilizing a medial congruent (MC) polyethylene liner between January 1, 2020 to December 31, 2020. All included patients were subsequently sent a survey package via mail to complete. Patients who did not return mail packages were contacted via phone.

Results

We included 188 patients in the final analysis. There was no statistical difference between the groups in regards to age (p = 0.77), sex (p = 0.075), BMI (p = 0.22), hospital stay (p = 0.86), laterality (p = 0.51), ASA score (p = 0.52), Kellgren Lawrence medial compartment OA score (p = 0.33) and Kellgren Lawrence lateral compartment OA score (p = 0.49). There was a statistically significant difference in favour of the control group (patella not resurfaced) with the KOOS JR score (p = 0.045). This difference was not observed with the Kujala score (p = 0.98) and the Oxford knee score (0.89).

Conclusion

There might be a role in performing a patella resurfacing, even in newer total knee designs. We did not observe a clinically meaningful difference in PROMS between PR and non-PR TKA at medium-term follow-up. In addition, we did not observe any demographic factors that influenced the surgeon's decision to perform patella resurfacing. Further high-quality research is warranted.