Patellectomy: An overview with reconstructive procedures

Patellectomy is a relatively old procedure and its effect on knee function has been a matter of controversy. Although indications for a patellectomy h ave been narrowed, patellectomy still is indicated as the last choice of tr eatment in certain situations including comminuted fractures, advanced chon dromalacia or osteoarthritis, dislocations, infections, and tumoral conditi ons. Excision of the patella results in a decrease in the moment arm of the extensor mechanism, alteration of the forces acting on the tibiofemoral jo int and instant center of motion, limitation of range of motion, anterior i nstability, loss of protection of the trochlea from injury, and poor cosmes is. A good technique of patellectomy should overcome all or at least some o f these problems. Although comparison of various techniques of patellectomy is impossible because of the lack of prospective randomized trials, reinfo rcement techniques seem more logical than simple repair procedures.