COMPARISON OF PATELLAR RESURFACING AND NONRESURFACING IN TOTAL KNEE ARTHROPLASTY - A PROSPECTIVE RANDOMIZED STUDY

This study was conducted to evaluate the advantages and disadvantages of patellar resurfacing in total knee arthroplasty. One hundred consec utive total knee arthroplasties were performed by the authors. The kne es were randomized into two groups of 50 knees, pre-operatively. Five patients (knees) dropped out during follow-up. There were 95 knees lef t for evaluation (47 in the resurfaced group, 48 in the nonresurfaced group). There were 71 women and 20 men. Seventy patients had osteoarth ritis (72 knees) and 21 patients rheumatoid arthritis (23 knees). Clin ical review was undertaken 2-3 years after operation. The mean follow- up time was 30 months. The patellofemoral joint was graded radiogaphic ally before operation. The state of the patellar cartilage was noted a nd staged intraoperatively. The PFC knee prosthesis was used in all kn ees. Clinical results related to subjective assessment, patellar pain (case history and observed), the Knee Society knee and function scores and range of movements. Patients with nonresurfaced patellae complain ed of anterior knee pain (all grades) in relation to 11 knees. Grindin g and compression of the patella was painful in relation to 22 knees. The corresponding figures in the resurfaced group were one and four. T he differences are statistically significant (p < 0.01 and 0.001 respe ctively). There were no significant differences between the groups ass essed using the Knee Society scoring systems. No significant differenc e was found in the number of complications between the groups studied. The results of this prospective randomized study indicate that there was no significant difference in knee function after total arthroplast y whether or not the patella had been resurfaced at the time of operat ion, but that resurfacing guarantees a pain-free knee in most cases.