LONG-TERM SURVIVAL RATES ARE SIMILAR WITH OR WITHOUT PATELLAR RESURFACING AFTER TOTAL KNEE ARTHROPLASTY, HOWEVER, HIGHER REVISION RATE WITHOUT PATELLAR RESURFACING CAN BE PROSTHETIC-SPECIFIC: A NATIONAL JOINT REGISTRY ANALYSIS

Abstract

AbstractIntroductionThe role of patellar resurfacing in total knee arthroplasty remains controversial. We questioned the effect of patellar resurfacing on the early and late revision rates after total knee arthroplasty.Materials and MethodsWe analysed the data of cumulative revisions of primary knee replacement from the NJR 19th Annual Report. NJR included secondary patellar resurfacing as a revision. We compared differences in the 3-year and 15-year revision rates between the patellar resurfacing and non-resurfacing for the different combinations of total knee replacements using a paired t-test. We performed subgroup analysis for the five combinations with the highest volumes.ResultsTwenty-seven implant combinations had the 15-year revision rates reported. Patellar resurfacing group had lower mean 3-year revision rate of 1.68 (SD 0.7) compared to 2.02 (SD 0.9) in non-resurfacing group (p=0.05). However, 15-year revision rate was similar between the two groups (mean 5.7, SD 2.1 vs. mean 5.7, SD 2.2; p = 0.46).High volume implants showed that two combinations (NexGen CR and PS) had similar revision rates at 3 and 15 years between resurfacing and non-resurfacing groups. Three combinations (PFC Sigma CR and PS and Genesis 2 CR) had higher revision rate in non-resurfacing group at 3 years (p=0.01) and the difference persisted at 15 years (p=0.05).ConclusionsAlthough revision rate in total knee arthroplasty was higher without patellar resurfacing at 3 years, at 15 years the difference was not significant. However, the higher revision without patellar resurfacing can be prosthetic combination specific which surgeons need to be aware of.