Outcomes and Survivorships of Total Knee Arthroplasty Comparing Resurfaced and Unresurfaced Patellae.

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Abstract

[Indexed for MEDLINE] 8. Diagnostics (Basel). 2023 Jan 19;13(3):383. doi: 10.3390/diagnostics13030383. Patellar Resurfacing in Total Knee Arthroplasty, a Never-Ending Controversy; Case Report and Literature Review. Adam R(1)(2), Moldovan C(3)(4), Tudorache S(5), Hârșovescu T(5), Orban C(6)(7), Pogărășteanu M(8)(9), Rusu E(10). Author information: (1)Department of Orthopedics and Traumatology, Elias Emergency University Hospital, 011461 Bucharest, Romania. (2)Department of First Aid and Disaster Medicine, Faculty of Medicine, Titu Maiorescu University of Bucharest, 040051 Bucharest, Romania. (3)Department of Clinical Sciences, General Surgery, Faculty of Medicine, Titu Maiorescu University of Bucharest, 040051 Bucharest, Romania. (4)Department of General Surgery, Witting Clinical Hospital, 010243 Bucharest, Romania. (5)Department of Preclinical Sciences, Anatomy and Embryology, Faculty of Medicine, Titu Maiorescu University of Bucharest, 040051 Bucharest, Romania. (6)Department of Anesthesia and Intensive Care, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania. (7)Intensive Care Unit Department, Monza Oncology Hospital, 013812 Bucharest, Romania. (8)Department of Orthopedics and Traumatology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania. (9)Department of Orthopedics and Traumatology, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania. (10)Department of Preclinical Sciences, Biochemistry, Faculty of Medicine, Titu Maiorescu University of Bucharest, 040051 Bucharest, Romania. Total knee arthroplasty (TKA) remains a lifesaving procedure for advanced gonarthrosis. However, patella resurfacing (PR) in TKA remains a controversial procedure, leading to extensive discussions amongst orthopedic surgeons, regarding its indications and results. Based on these premises, we present a clinical case of a 70-year-old Caucasian woman admitted for pain, swelling and limitation of left knee joint mobility. Her medical history records an Ahlback stage IV gonarthrosis with simultaneous bilateral TKA surgery performed in different hospital, when two NexGen cemented total prostheses were implanted with patellar resurfacing being performed only on the right side. Our clinical (American Knee Society Score, Lonner and Feller scales) and radiological evaluations (CT scan and Xray) revealed left patellar arthrosis and a slight lateral subluxation of the patella. The chosen treatment plan was revision surgery for PR and patellar prosthesis with a cemented patellar component, cross-linked polyethylene, no 32 NexGen model with 8.5 mm thickness. The immediate and distant postoperative evolution was favorable. Extensive literature review shows that, at present, PR remains at surgeon's discretion mainly based on his previous results. Therefore, we believe there is an imperative need to develop high quality studies based on accurate scientific evidence to universally establish valid guidelines for PR in TKA. DOI: 10.3390/diagnostics13030383 PMCID: PMC9914207