FREEHAND RESECTION OF THE PATELLA IN TOTAL KNEE ARTHROPLASTY REFERENCING THE ATTACHMENTS OF THE QUADRICEPS TENDON AND PATELLAR TENDON

A freehand technique of patellar resurfacing using anatomic references was prospectively evaluated. This technique utilizes an osteotomy beg inning at the inferior pole of the patella just posterior to the inser tion of the patellar tendon and is carried proximally posterior to the insertion of the quadriceps tendon. Evaluation of 55 total knee arthr oplasties in 41 patients showed an average restored patellar thickness within 0.1 mm. The overall patellar thickness was restored to within 1 mm of its preoperative thickness in 50 (91%) of 55 knees. Patellar t ilt was equal to or less than 4 degrees in 42 (89%) of 47 arthroplasti es evaluated radiographically. The patellar thickness averaged 17.9 mm . well above the critical value of 15 mm reported in the literature.