PATELLAR RESURFACING OR RETENTION IN TOTAL KNEE ARTHROPLASTY - A PROSPECTIVE-STUDY OF PATIENTS WITH BILATERAL REPLACEMENTS

Patellofemoral problems are a common cause of morbidity and reoperatio n after total knee arthroplasty. We made a prospective study of 52 pat ients who had bilateral arthroplasty (104 knees) and in whom the patel la was resurfaced on one side and not on the other. A movable-bearing prosthesis with an anatomical femoral groove was implanted on both sid es by the same surgeon using an otherwise identical technique. The mea n follow-up was 5.24 years (2 to 10). In the 30 available patients (60 knees) there was no difference between the two sides in subjective pr eference, performance on ascending and descending stairs or the incide nce of anterior knee pain. Radiographs showed no differences in prosth etic alignment, femoral condylar height, patellar congruency or joint line position. The use of an appropriate prosthetic design and careful surgical technique can provide equivalent results after knee arthropl asty with or without patellar resurfacing. Given the indications and c riteria, which we discuss, retention of the patellar surface is an acc eptable option.