Purpose
Resurfacing the patella in total knee arthroplasty(TKA) is a controversial procedure. Although there are some advantages to replace the patella, there is a conservative trend among some surgeons who prefer to retain it, leading to a faster procedure, preserving bone stock, with fewer complications and similar outcomes. Traditional procedure consists in removing the osteophytes and performing a denervation around the patella. A different approach is to perform a patelloplasty, defined as reshaping the patella for optimal tracking in the trochlea. The objective of this study was to compare the results between traditional preservation and patelloplasty in osteoarthritis patients treated with primary TKA.
Material And Methods
25 patients underwent bilateral non-simultaneous TKA with the preservation of the native patella, and the same implant in both knees. On one side, patellar denervation and osteophytes resection was performed, and on the other one, patelloplasty. All implants were patellar "friendly" throclea design. 19 patients were evaluated with the average age of 74 years(61 to 89), BMI of 29.7, and the follow up of 4.3 years(2.9 to 7.8) in the traditional patella preservation group and 1.7 years(0.6 to 2.8) in the patelloplasty. The patients were asked which side had the most satisfactory result, in their opinion. Range of motion(ROM), VAS, and KSS, Forgotten knee, KOOS and LEE scores were also evaluated.
Results
8 (42%) of the patients did not have a preference side, 7 (37%) preferred traditional preservation knee, and 4 (21%) the patelloplasty. Regarding pain, VAS was 1.2 in the traditional and 2 in the patellopalsty. The ROM was similar, showing 126.4 degrees in the traditional side and 126 in the patelloplasty. The differences in KSS (score and function), Forgotten, KOOS and LEE scores between both groups, were not statistically significant.
Conclusions
Patelloplasty is a safe procedure, with few complications, relieving pain, with functional outcomes similar to those of the traditional procedure.