PATELLAR RESURFACING IN TOTAL KNEE ARTHROPLASTY FOR OSTEOARTHRITIS. A SYSTEMATIC REVIEW OF STUDIES WITH A MINIMUM 5 YEAR FOLLOW-UP.

Abstract

A systematic review was performed to determine the advantages and disadvantages of patellar resurfacing during total knee replacement for osteoarthritis. 3 randomised controlled studies were analysed. These studies recruited 302 knees and 277 knees (92%) were reviewed at least 5 years postoperatively (range 5 to 10 years). Patients undergoing patellar resurfacing received a cemented all polyethylene patella component. A patelloplasty was performed in some of the unresurfaced knees.

Each outcome measure tested was assessed for heterogeneity using the Cochran Q test. If significant heterogeneity was present (P< 0.10), data from the studies was not combined and the studies were examined for possible explanations. If there was no significant heterogeneity, a combined odds ratio was calculated using a fixed effects model and a Z test was performed to test the overall effect. Reoperation for patellofemoral problems was significantly more likely in the unresurfaced group (p=0.003). The overall rate for reoperation for a patellofemoral problem was 0.7% in the resurfaced group and 12% in the unresurfaced group. Study data on clinical knee scores and anterior knee pain could not be analysed together as there was significant heterogeneity. There was no difference between the two groups in terms of revision. This study found no mid- to long-term benefit to leaving the patella unresurfaced.