Patellar Resurfacing In Total Knee Replacement

Abstract

The need for patellar resurfacing during total knee replacement presents a dilmma for the orthopedic surgeon. There are proponents for patellar resurfacing who point out what this is a logical step in total knee replacement and that it gives predictable results.

Resurfacing of the patella was not a feature of many desii,'TlS of total knee prosthesis. The occurrence of postoperative patella- femoral pain, pa1ticularly in patients who had rheumatoid arthritis, resulted in the incorporation of patello- femoral resurfacing into most subsequent designs with the advent of modem condylar components, resurfacing of the patella became a standard part of total knee arthroplasty.

The incidence of pallelar pam m early designs of tibiofemoral replacement led to recommendations for patellar resurfacing, but these tri- compartmental replacement had problems of component wear. loosening. fracture, ligament and tendon ruptures, mal- tracking and knee pain. Patello- femoral problems, seen in 5% to 30% of tri­ compaitmental desii,'TlS, have become a major cause of morbidity and re -operation in TKA with patella resurfacing.