Patellar resurfacing in total knee arthroplasty

Abstract

Patellar resurfacing in total knee arthroplasty remains controversial as there is evidence both in favor of and against routine resurfacing. We aimed to evaluate the effectiveness of this technique through a critical appraisal of the available literature. We performed a review of all available randomized controlled trials (RCTs) on MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials, and compared total knee arthroplasties performed with and without patellar resurfacing. References of retrieved articles were also reviewed regardless of the study is whether for total knee arthroplasty, surgical technique, or specific types of prosthesis used. There was no language restriction at the time of search. Outcomes of interest included incidence of reoperations, prevalence of postoperative anterior knee pain, and improvement in various knee scores. The relative risk of reoperation is significantly lower in the patellar resurfacing group than the nonresurfacing group (RR: 0.52, 95% CI). The possibility of anterior knee pain is also reduced in patellar resurfacing group compared to nonresurfacing group with the RR of 0.56 (95% CI, P < 0.00001) with no significant difference in functional outcome between the two groups. The existing literature shows that patellar resurfacing can reduce the risk of reoperation with no improvement in knee function or patient satisfaction compared to patients without patellar resurfacing. If it reduces, the incidence of anterior knee pain remains uncertain at present.