Comparison of radiological and clinical assessments patellar resurfacing with retention for late stages of knee osteoarthritis performed total knee arthroplasty
Introduction: the purpose of this prospective study was to compare radiological and clinical outcomes after total knee arthroplasty (TKA) with or without patellar resurfacing in patients with grade IV osteoarthritis on patellofemoral joint.
Materials and Methods: 123 cases with Kellgren-Lawrence grade IV osteoarthritis on patellofemoral joint were enrolled for this study. At the operating room they were randomly assigned to undergo patella resurfacing (62 cases) or patella retention (61 cases). Among them, 114 cases that could be followed for more than 2 years were included in this study (resurfacing group; 59 cases, retention group; 55 cases). Preoperative and postoperative radiological and clinical outcomes (mechanical femorotibial angles, patellar tilt, congruence angle, WOMAC score and ROM) were evaluated and compared between two groups.
Results: preoperative radiological measures show insignificant difference between patellar tilt (P = 0.13), mechanical femorotibial angles (P = 0.62) and congruence angle (P = 0.37). Despite the difference performed methods of surgery, postoperative radiological assessment outcomes between two groups were almost identical Patellar tilt (P = 0.47), mechanical femorotibial angles (P = 0.34) and congruence angle (P >0.05). WOMAC score after surgery was 31.7 ± 6.4 point in resurfacing group, 29.2 ± 6.9point was in retention group without significant intergroup difference. And there was no significant difference ROM in both groups respectively. There was no significant difference between two groups in mechanical axis of the lower limb and patella tilt, patella congruence.Conclusion: obtained almost the same satisfactory radiological and clinical outcomes after patella resurfacing and retention groups after TKR allows us to conclude that, primary TKA without patellar resurfacing is a good treatment option in patients with high grade osteoarthritis of the patellofemoral joint.
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