| Background:The knee is the largest and most complicated structure body movement function of joints demanding.Artificially total knee replacement can alleviate joint pain and improve knee function, has become the main treatment of various serious arthritis surgical treatments, and achieved good curative effect, its 10 years fine rate in more than 90%.In the early 20th century, the importance of patella, not for what people value, and total knee prosthesis design without patellar components, before the incidence of postoperative painful knee 40%-58%. Since 1971 kaufer report patellar mechanical functions, the importance of patella is known by people. However, in the rapid development of artificial knee, meanwhile,Totalknee replacement(TKA) whether arthroplasty, displacement patellar is still a biggish contentious issue.Objective:This article will mainly to contrast the Total knee replacement (TKA) patellar replacement and patellar not surgery knee functional score, reoperation risk, knee area before the pain relief situation, patient satisfaction and complications study, system evaluation patellar replacement and patellar not replacement in Total knee arthroplasty (TKA) after the clinical curative effect, so as to find out a more safe and effective method for clinical services.Methods:Comprehensive search on knee arthroplasty at home and abroad in patellar replacement and patellar not of the replacement of a randomized study material, according to the established into, exclusion standard, check and ratify detected accord with the evaluation criteria of literature, extraction required research data, using the RevMan 4.2 software Meta analysis.Results:There are a total of 20 trials which meet the test requirements included total knee replacement 2232 cases.Of which 1121 cases had patellar replacement,1111 patients without replacement of the patella.Meta analysis showed that:(1),Replacement group than in the patella without patellar replacement reduces postoperative anterior knee pain in RR=0.56,95%CI(0.36,0.87), according to follow-up time for sub-group analysis:Patellar replacement group occurred after 5 years,reduce the risk of anterior knee pain RR=0.51,95% CI(0.32,0.79);but after 5 years RR=0.61,95%CI(0.28,1.34), no significant difference between the two.(2),Replacement group than in the patellar patellar replacement group did not reduce the risk of re-operation after RR= 0.44,95%CI(0.29,0.65), according to follow-up time for sub-group analysis:Patellar replacement group after 5 years the risk of re-operation after the low RR= 0.27,95% CI(0.14,0.52);but within 5 years was no significant difference between the two RR=0.61,95%CI (0.37,1.00).(3),Whether the overall analysis or subgroup analysis by follow-up time and the patellar patellar replacement group of patients between the groups are not free replacement level and KSS knee function score were not statistically different.Conclusion:(1),total knee arthroplasty in patellar replacement and patellar not replacement operation that five years' knees hurt occurrence rate is low, but 5 years both does not have significant difference;(2),total knee arthroplasty in patellar replacement group and patellar not replacement group began again surgical risk, compared to patellar replacement group began five years later reoperation low-risk, but 5 years both does not have significant difference;(3),whether it's overall analysis or by the follow-up time subgroup analysis patellar replacement group and patellar not replacement group between patients immune degree and the knee KSS functional score were not statistically significant; (4),because in the existing selective bias and measuring biasing the possibility of this research results, will naturally evidence strength produce certain effect and conclude need large sample, and long-term follow-up multimember randomized controlled trial to further proved.
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