The Importance of Patellar Resurfacing in Total Knee Arthroplasty for Symptomatic Valgus Degenerative Deformity.

Abstract

PURPOSE OF THE STUDY Patellar surface replacement during total knee arthroplasty is still a matter of discussion among orthopedic surgeons. The purpose of this study was to examine possible benefits of patellar surface replacement in selected patients with symptomatic degenerative valgus deformity. We have not found any studies in the literature that compare the results of patella management solely for valgus or varus knee deformity nor those that compare both. MATERIAL AND METHODS Patients were randomly assigned to a group that would receive patellar surface replacement during total knee arthroplasty and a group of patients in whom total knee arthroplasty was performed without patellar surface replacement. 60 patients were included in the study. Total knee arthroplasty with patellar resurfacing (TKAPR) was performed in 30, and without PR (TKA) in 30 of them. Results were prospectively gathered and compared at regular intervals. RESULTS There were no significant differences between groups for examined parameters except for Oxford Knee Score at 6 months which was in favor of patellar resurfacing group. DISCUSSION The decision whether to replace the patella or not is currently exclusively a matter of surgeon's choice. Establishing selection criteria for patients that would benefit from patella resurfacing could, therefore, be very useful for both patients and orthopaedic surgeons performing total knee replacement. CONCLUSIONS Although evidence in our study could not strongly suggest performing patella resurfacing in patients with valgus deformity, the results were slightly better in the patella resurfacing group and this trend could increase if larger series of patients would be employed. A longer follow-up period would be required for clear-cut decisions and more prospective studies are warranted. Key words: knee, arthroplasty, patella, replacement, valgus, deformity.