Abstract

Background: The management of the patella during primary total knee arthroplasty (TKA) is controversial. The most common methods of treating the patella in TKA are patellar resurfacing and non-surfacing patelloplasty. Objectives: The aim of this study was to assess short term outcomes of non-surfacing patelloplasty in primary total knee arthroplasty. Patient and methods: This study included a total of twenty patients who had primary total knee arthroplasty for degenerative or inflammatory arthritis accompanied with moderate to severe patellofemoral arthritis attending at Al-Azhar University Hospitals. Patelloplasty was done in the form of excision of peripatellar synovial tissues, osteophytectomy and denervation of patellar rim using electro-cautery and smoothing of the articular surface by oscillating saw. Results: All patients were examined using a new patellofemoral scoring system,after one year follow up after total knee arthroplasty (TKA) the end result was: 14 patients were very satisfied, while 5 patients had mild to moderate anterior knee pain, tolerated by analgesics on demand and physiotherapy. Only one case had severe pain and secondary resurfacing was done about 6 months postoperatively, the patient was satisfied, and the pain became mild. Discussion: Total knee arthroplasty (TKA) is one of the most commonly performed operations in adult reconstructive surgery. The management of the patella in primary TKA remains controversial. The approaches available for patellar management in TKA are non-resurfacing patelloplasty, and selective resurfacing. Conclusion: It is recommended to do patelloplasty without resurfacing of the patella as this technique has fewer hazards and complications. Keywords: anterior knee pain, patellar denervation, patelloplasty, total knee arthroplasty.

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