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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 5, 675-678.
doi: 10.1302/0301-620X.85B5.13787  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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Secondary resurfacing of the patella for persistent anterior knee pain after primary knee arthroplasty

H. E. Muoneke, MSc, FRCS, Research Registrar in Trauma and Orthopaedics1; A. M. Khan, FRCS, FRCS (Orth), Specialist Registrar in Orthopaedic Surgery1; K. A. Giannikas, FRCS, Specialist Registrar in Orthopaedic Surgery1; E. Hägglund, RGN BSc, Nurse Practitioner in Orthopaedics1; and T. H. Dunningham, FRCS, Consultant Orthopaedic Surgeon1

1 Orthopaedic Department, Tameside General Hospital, Fountain Street, Ash-ton-under-Lyne OL6 9RW, UK.

Correspondence should be sent to Mr K. A. Giannikas.

Out of a total of 623 patients who, over a ten-year period, underwent primary total knee replacement (TKR) without patellar resurfacing, 20 underwent secondary resurfacing for chronic anterior knee pain.

They were evaluated pre- and postoperatively using the clinical and radiological American Knee Society score. The mean follow-up was 36.1 months (12 to 104). The mean knee score improved from 46.7 to 62.2 points and the mean functional score from 44.7 to 52.2 points. Only 44.4% of the patients, however, reported some improvement; the remainder reported no change or deterioration. The radiographic alignment of the TKR did not influence the outcome of secondary resurfacing of the patella. Complications were noted in six of the 20 patients including fracture and instability of the patella and loss of movement.

Anterior knee pain after TKR remains difficult to manage. Secondary resurfacing of the patella is not advocated in all patients since it may increase patient dissatisfaction and hasten revision.




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D. G. Campbell, W. W. Duncan, M. Ashworth, A. Mintz, J. Stirling, L. Wakefield, and T. M. Stevenson
Patellar resurfacing in total knee replacement: A TEN-YEAR RANDOMISED PROSPECTIVE TRIAL
J Bone Joint Surg Br, June 1, 2006; 88-B(6): 734 - 739.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General