Total Knee Arthroplasty: Patella Resurfacing Versus Nonresurfacing

　　　　　The results of total knee arthroplasty (TKA) with or without patellar resurfacing were retrospectively evaluated in 164 knees of 128 patients. All of the patients received primary total knee arthroplasty using a Miller-Galante I prosthesis. Hybrid fixation including non-cemented femoral component with cemented tibial and patellar components was used in this series. The patella was resurfaced with cemented metal-backed patellar component when there was either gross destruction or eburnation of the articular surface. Hospital for Special Surgery (HSS) knee score, radiographic examination and muscle strength using isokinetic assessment were used to evaluate the functional status of knees. One hundred TKAs with patellar resurfacing and 64 TKAs without patellar resurfacing were evaluated. The average duration of follow-up was 4.8 years. The demographic data were similar between two groups. Less preoperative HSS knee score and more knee score improvement were found over the resurfacing group (p < 0.05). Yet, no significant difference over the HSS knee score at the final assessment existed between two groups (p > 0.05). The resurfacing group had better muscle torque balance (Hamstring/Quadriceps ratio) than the nonresurfacing group (p < 0.05). There were more postoperative complications in the resurfacing group (21%) than the nonresurfacing group (4.7%). Seventeen patellar polyethylene wear in the resurfacing group caused chronic pain or click and required the revision surgery (17 percent). Although TKA with patellar resurfacing acquires similar good knee's functional recovery as in TKA without resurfacing, yet, it had high patellar complications of this design. Therefore, selective patellar resurfacing might be considered in primary TKA.