Dr. Aashay Sonkusale,
Fellow in Arthroplasty and Arthroscopy, Apollo Hospital Chennai, Tamil Nadu, India.
E-mail: sonkusaleaashay614@gmail.com
Patella resurfacing in total knee arthroplasty has always been a topic of debate among the orthopedic surgeons around the world since its introduction in 1975 by Insall-Burstein. The results of current technique of PR has the promise lesser re-operations rates and cost-effectiveness in the long run, it is not albeit complications such as fracture, overstuffing of the patellofemoral joint, and maltracking of patella. Recent patella-friendly implants such as single radius anatomic femoral component and medial pivot knee have better patellar kinematic profiles with a deeper trochlear groove, a lateralized trochlear axis in the sagittal plane improving patellar contact force distribution. This has reduced the incidence of anterior knee pain following TKA, although there are other causes which have to be borne in mind when dealing with post-TKA AKP. Non-resurfacing of patella although claim to have similar patient-related outcome measures in the long run, lower patient satisfaction, and anterior knee pain have been deterrents to its absolute acceptance. Other methods such as cautery denervation (CD) and patelloplasty also boast functional outcomes similar to resurfacing with the advantages of being time effectivity, easy, and safe. There is considerable non-uniformity with these non-resurfacing techniques, depending on the surgeon’s preference and training. Selective resurfacing in “at-risk patellae” identified by pre- and intra-operative characteristics is increasing gaining popularity. We undertake a narrative review of the resurfacing of the patella focusing on anterior knee pain and functional outcomes.
Keywords: Patellar resurfacing, non-resurfacing, selective re-surfaces, anterior knee pain, knee society score.
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