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 235 knees (78%) were reviewed at least 5 years postoperatively (range 5 to 10 years). Patients undergoing patellar resurfacing received a cemented all polyethylene patella component. A patello-plasty was performed in some of the unresurfaced knees.
For the dichotomous data, odds ratios and 95% confidence intervals were calculated. 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. 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 11% in the unresurfaced group. Study data on 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.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
