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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_15 | Pages 40 - 40
1 Mar 2013
Clarke H Spangehl MJ
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Introduction

Patellar resurfacing during Total Knee Arthroplasty (TKA) is controversial. Problems unique to patellar resurfacing may be influenced by available patellar component design. These issues include; over-stuffing (the creation of a composite patellar-prosthesis thickness greater than the native patella) that may contribute to reduced range of motion; and over-resection of the native patellar bone that may contribute to post-operative fracture. Prosthesis design may play a role in contributing to these problems. Component diameter and thickness are quite variable from one manufacturer to another and little information has been previously published about optimal component dimensions. This anatomic study was performed to define the native patellar anatomy of patients undergoing TKA, in order to guide future component design.

Methods

This retrospective, IRB approved study reviewed 797 Caucasian knees that underwent primary TKA by a single surgeon. Data recorded for each patient included: gender; patellar thickness before and after resurfacing, and the size of the component that provided the greatest patellar coverage without any overhang. The residual patellar bone thickness after resection was also calculated.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XL | Pages 179 - 179
1 Sep 2012
Spangehl MJ Clarke HD
Full Access

Introduction

Opponents of patellar resurfacing during Total Knee Arthroplasty (TKA) note unique complications associated with resurfacing. Problems include over-stuffing (the creation of a composite patellar-prosthesis thickness greater than the native patella) that may contribute to reduced range of motion; and creation of a patellar remnant that is too thin (in order to avoid over-stuffing) that may contribute to post-operative fracture. Factors including surgical technique, prosthesis design and patient anatomy may contribute to these problems. This study was performed to define the native patellar anatomy, and to compare the effect of differences in component thickness between manufacturers.

Methods

This retrospective, IRB approved study reviewed 803 knees that underwent primary TKA between 2005 and 2011 with a single surgeon. Patellar resurfacing was performed with a round, polyethylene component from one of two different implant designs using the same surgical technique. Data recorded for each patient included: gender; patellar thickness before and after resurfacing; the dimensions and manufacturer of the prosthesis. The residual patellar bone thickness after resection was calculated.