Patella Resurfacing in Total Knee Arthroplasty: A Series of 1280 Patients at Midterm Follow-Up.

Background: The management of patella in total knee arthroplasty (TKA) is a controversial topic. The elevated risk of patellofemoral complications seems to support those who are not eager to perform such procedure. The aim of this study is to carry out a retrospective assessment of patients who underwent patellar resurfacing during TKA from 2004 to 2009.

Methods: From January 1, 2004, to December 31, 2009, 1280 patients underwent TKA with patellar prosthesis implantation. Of them, 861 patients (639 women and 222 men with an average age of 67.7 ± 12.3 years) were available for a telephonic interview consisting of the questions included in the Knee Pain Score (KPS). Patients presenting KPS >36 and those subjected to reoperation were then evaluated clinically and radiologically.

Results: Of the 861 patients included in the study, 801 showed a KPS <36. Among the remaining 60 patients, 33 had a KPS >36, while 27 had been reoperated at the target knee. In the former case, a decrease in normal Insall-Salvati index and patellar tilt values (from 1.08 to 1.02 and from 9.3 to 9.1, respectively) and average anatomic axis (from -2.6° to 1.1°) was found comparing preoperative with last follow-up evaluation. Only in 0.6% of the cases of reintervention, patellofemoral complications were found to be the cause.

Conclusion: This study conducted on a large and homogenous group of patients confirms a very low rate of complications related to patella resurfacing during TKA.