Comparative Analysis of Resurfaced and Unresurfaced Patella in Bilateral Total Knee Arthroplasty: A 10 year, Prospective and Controlled Study of Clinical and Radiological Results

Abstract

Purpose: To analyze the clinical and radiological results of bilateral TKA with and without patellar resurfacing in osteoarthritic patient. Materials and Methods: We have prospectively studied 17 patients who had bilateral TKA and whose patella was resurfaced on one side and not on the other. Criteria of patient selection include no preoperative patellofemoral pain and bony eburnation of articular cartilage. The Ortholoc Modular prosthesis was implanted on both sides by same surgeon using identical technique in all cases. The mean follow- up period was 10.6 years. Evaluation was performed annually using HSS (Hospital for Special Surgery) knee rating score and radiological parameters including tibiofemoral angle, width of patella, length of patella, thickness of patella, tilt of patella and shift of patella. Results: On the basis of long term follow-up results, there was no significant difference between resurfaced and unresurfaced group in clinical and radiological study. According to radiological findings as time passed, tibiofemoral angle and patellar thickness decreased but patellar length and width increased in both groups. There was no relationship between HSS knee score and radiological result in both groups. Conclusion: This study showed that long term clinical and radiological results of TKA does not depend on patellar resurfacing. Author can propose that patellar resurfacing is not always required in patients with relatively good condition in articular surface of patella. Key Words: Total knee arthroplasty, Patella, Resurfacing, Retention.