THE MILLER-GALANTE KNEE ENDOPROSTHESIS WI THOUT PATELLAR RESURFACING - FIRST CLINICAL-RESULTS

20 patients with 23 knee joints who had been provided with a Miller-Ga lante knee endoprosthesis without patellar resurfacing because of infl ammatory destruction or arthrosis were examined 22 months postoperativ ely on average. Compared to a group of 60 knee joints which had receiv ed Miller-Galante prostheses with an alloarthroplastic replacement of the patella at an earlier point in time, there were no differences in function and pain in the operated knee joints. The knee score which wa s evaluated in accordance with the assessment system of Insall (maximu m 75 points) improved from 15.2 points preoperatively to 64 points pos toperatively in group 1 (patients with patellar resurfacing), in group 2 (patients without patellar resurfacing) the improvement was from 18 .8 points preoperatively to 65.1 points postoperatively. The function score (maximum 100 points) was 37 points preoperatively and 81.7 point s postoperatively in group 1, in group 2 19.2 and 82.3 points. We do n ot carry out patellar resurfacing when there is a sufficient covering of cartilage retropatellar, i.e. that the arthrosis has not progressed so far that hard, ebonized subchondral bone lies exposed. Moreover a normal gliding behaviour of the patella must be guaranteed after impla ntation of the artificial joint. In most cases normal articulation bet ween the patella and the artificial joint can be restored by the remov al of marginal osteophytes (alloplastic conversion of the patella) in combination with a lateral division of the retinaculum.