Comparison Of Total Knee Arthroplasty With And Without Patellar Replacement

Objective To compare retrospectively the clinical outcome of total knee arthroplasty (TKA) with and without patellar replacement. Method From January 2001 to December 2004, 82 knees in 62 patients with TKA were evaluated postoperatively using a questionnaire and physical examination. There were 18 males and 44 females with the age ranging from 45 to 84 years (average 67 years). The primary diagnosis was osteoarthritis in all patients. Fifty-three knees underwent patellar replacement, while 29 knees with reserved patella. The patients were scored using HSS Score system for knees and Feller Score systemfor patella. Anteroposterior and lateral views of the knee as well as axial views of the patella were taken in radiography. The data were analyzed using SPSS software. Results Replacement and nonreplacement groups showed no obvious diference in postoperative HSS score and the incidence of patellar complication. The two groups showed statistical significant diferences in scoring on climbing and descending stairs and rising from sitting position, the results suggested that the patellar function score of the replacement group was better than that of the nonreplacemet group. Postoperative anterior knee pain occurred more commonly in the nonreplacement group and showed significant diference (P<0.05) between the two groups, although the pain was mostly mild in degree. Conclusions Patients who underwent patellar resurfacing had superior clinical results in terms of anterior knee pain and patellar function. These findings suggest that, in order to decrease anterior knee pain and improve patellar function postoperatively, selective replacement of the patella during total knee arthroplasty is preferable for patients with osteoarthritis.