Abstract
Abstract
Background
The decision to resurface the patella as part of total knee arthroplasty may be influenced by the surgeon’s preference, education, training, tradition and geographic location. Advocates for non-resurfacing or selectively resurfacing may claim no difference in patient reported outcomes, and that resurfacing is associated with increased risks such as extensor mechanism injury or malalignment, problems with the design of the patella component and technical issues intraoperatively.
Aims
To critically examine factors that should be considered in addition to patient reported outcomes in the decision process of resurfacing or non-resurfacing of the patella in total knee arthroplasty.
Method
A comprehensive literature search was conducted to identify factors that may influence decision making in addition to knee specific patient reported outcome measures such as surgical risks, patient quality of life, procedure cost, re-operation rate, implant design, surgeons learning curve and the fate of remaining cartilage in native patellae.
Results
Patient-reported outcomes are equivocal for resurfacing and non-resurfacing. Critical analysis of the available literature suggests that the complications of resurfacing the patella are historic, which is now lower with improved implant design and surgical technique. Routine resurfacing was cost-effective in the long term (potential saving £104 per case) and has lower rates of revision (absolute risk reduction 4%). Finally, surgical judgment in selective resurfacing was prone to errors.
Conclusion
Patella resurfacing and non-resurfacing had similar patient-reported outcomes. However, patella resurfacing was cost-effective and was associated with a lower rate of re-operation compared to non-resurfacing.
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,Surgery
Reference70 articles.
1. Academy of Orthopaedic Surgeons A. American Joint Replacement Registry | 7th Annual Report. 2020. Available from: http://connect.ajrr.net/2020-ajrr-annual-report
2. Ireland NJR for EW and N. National Joint Registry | 17th Annual Report. 2020 [cited 2020 Dec 11]. Available from: https://reports.njrcentre.org.uk/Portals/0/PDFdownloads/NJR 17th Annual Report 2020.pdf
3. Ali A, Lindstrand A, Nilsdotter A, Sundberg M. Similar patient-reported outcomes and performance after total knee arthroplasty with or without patellar resurfacing. Acta Orthop. 2016;87(3):274–9 [cited 2020 June 9]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/27212102.
4. Parvizi J, Rapuri VR, Saleh KJ, Kuskowski MA, Sharkey PF, Mont MA. Failure to resurface the patella during total knee arthroplasty may result in more knee pain and secondary surgery. Clin Orthop Relat Res. 2005;438 [cited 2020 Dec 5]. Available from: https://pubmed.ncbi.nlm.nih.gov/16131890/.
5. Li S, Chen Y, Su W, Zhao J, He S, Luo X. Systematic review of patellar resurfacing in total knee arthroplasty. Int Orthop 2011;35:305–316. [cited 2020 Dec 14]. Available from: https://doi.org/10.1007/s00264-010-1109-2
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