Implantation of the patellar component in the total arthroplasty of the knee: current situation | Revista Española de Cirugía Ortopédica y Traumatología (English Edition)

Article information

Abstract

Introduction

Implanting or not implanting the patellar component (PC) in knee prosthesis (TKP) is a controversial subject.

Material and method

In an attempt to clarify this controversy, we have reviewed grade 1 and 2 scientific evidence articles.

Results

The percentage of anterior knee pain without PC ranges from 17% to 69% versus 5.3-37% when the PC is placed. Without PC, the percentage of reoperation goes from 0% to 20%, this being from 0% to 13% when the PC is implanted. A prospective study has demonstrated that the Outerbridge classification serves to decide on whether to perform a PC implant or not.

Conclusions

The controversial is still unsolved. For some authors, it is better to always place a PC. However, others state that it is not necessary to do so in Outerbridge grades I, II and III, being recommendable to do so in grade IV.

Keywords:

Knee

Arthroplasty

Patellar component

Resumen

Introducción

Implantar o no el componente rotuliano (CR) en prótesis de rodilla es un tema controvertido.

Material y método

Para intentar clarificar esta controversia hemos revisado artículos de evidencia científica grados 1 y 2.

Resultados

Sin CR, el porcentaje de dolor anterior de rodilla oscila entre 17-69% frente al 5,3-37% cuando se coloca el CR. Sin CR, el porcentaje de reoperación va de 0-20%, y es de 0-13% cuando se implanta el CR. Un estudio prospectivo ha demostrado que la clasificación de Outerbridge sirve para decidir si implantar o no el CR.

Conclusiones

La controversia sigue sin estar resuelta. Para algunos autores es mejor colocar siempre el CR. Sin embargo, otros señalan que no es necesario colocar el CR en los grados I, II y III de Outerbridge, y es aconsejable hacerlo en los grados IV.

Palabras clave:

Rodilla

Artroplastia

Componente rotuliano

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References

[1]

R.S. Burnett, R.B. Bourne.

Indications for patellar resurfacing in total knee arthroplasty.

J Bone Joint Surg (Am), 85-A (2003), pp. 728-745

[2]

C. Browne, J.C. Hermida, A. Bergula, C.W. Colwell, D.D. D‘Lima.

Patellofemoral forces alter total knee arthroplasty: Effect of extensor momento arm.

Knee, 12 (2005), pp. 81-88

http://dx.doi.org/10.1016/j.knee.2004.05.006 | Medline

[3]

I. Yoshii, L.A. Whiteside, Y.S. Anouchi.

The effect of patellar button placement and femoral component design on patellar tracking in total knee arthroplasty.

Clin Orthop Relat Res, 275 (1992), pp. 211-219

Medline

[4]

R.S. Nizard, D. Biau, R. Porcher, P. Ravaud, P. Bizot, D. Hannouche, et al.

A meta-analysis of patellar replacement in total knee arthroplasty.

Clin Orthop Relat Res, 432 (2005), pp. 196-203

Medline

[5]

E.E. Pakos, E.E. Ntzani, T.A. Trikalinos.

Patellar resurfacing in total knee arthroplasty. A meta-analysis.

J Bone Joint Surg (Am), 87-A (2005), pp. 1438-1445

[6]

J. Parvizi, V.R. Rapuri, K.J. Saleh, M.A. Kuskowski, P.F. Sharkey, M.A. Mont.

Failure to resurfae the patella Turing total knee arthroplasty may result in more knee pain and secondary surgery.

Clin Orthop Relat Res, 438 (2005), pp. 191-196

Medline

[7]

D. Mayman, R.B. Bourne, C.H. Rorabeck, M. Vaz, J. Kramer.

Resurfacing versus not resurfacing the patella in total knee arthroplasty. 8 to 10 year results.

J Arthroplasty, 18 (2003), pp. 541-545

Medline

[8]

R.L. Barrack, A.J. Bertot, M.W. Wolfe, D.A. Waldman, M. Milicic, L. Myers.

Patellar resurfacing in total knee arthroplasty.

J Bone Joint Surg (Am), 83-A (2001), pp. 1376-1381

[9]

D.G. Campbell, W.W. Duncan, M. Ashworth, A. Mintz, J. Stirling, L. Wakefield, et al.

Patellar resurfacing in total knee replacement. A ten-year randomised prospective trial.

J Bone Joint Surg (Am), 88-B (2006), pp. 734-739

[10]

R.S. Burnett, C.M. Haydon, C.H. Rorabeck, R.B. Bourne.

Patella resurfacing versus nonresurfacing in total knee arthroplasty. Results of a randomized controlled clinical trial at a minimun of 10 years followup.

Clin Orthop Relat Res, 428 (2004), pp. 12-25

Medline

[11]

R.E. Outerbridge.

The etiology of chondromalacia patellae.

J Bone Joint Surg (Br), 43-B (1961), pp. 752-757

[12]

Rodríguez-Merchán EC, Gómez-Cardero P. The Outerbridge classification predicts the need for patellar resurfacing in TKA. Clin Orthop Relat Res. 2009. In press.

[13]

T.S. Waters, G. Bentley.

Patellar resurfacing in total knee arthroplasty. A prospective, randomized study.

J Bone Joint Surg (Am), 85-A (2003), pp. 212-217

[14]

A.J. Smith, D.J. Wood, M.G. Li.

Total knee replacement with and without patellar resurfacing. A prospective, randomised trial using the Profix Total Knee System.

J Bone Joint Surg (Br), 90-B (2008), pp. 43-49

[15]

D.J. Wood, A.J. Smith, D. Collopy, B. White, B. Brankov, M.K. Bulsara.

Patellar resurfacing in total knee arthroplasty. A prospective, randomized trial.

J Bone Joint Surg (Am), 84-A (2002), pp. 187-193

[16]

P.A. Keblish, A.K. Varma, A.S. Greenwald.

Patellar resurfacing or retention in total knee arthroplasty. A prospective study of patients with bilateral replacements.

J Bone Joint Surg (Br), 76-B (1994), pp. 930-937

[17]

K.A. Levitsky, W.J. Harris, J. McManus, R.D. Scott.

Total knee arthroplasty without patellar resurfacing. Clinicals outcomes and long-term followup evaluation.

Clin Orthop Relat Res, 286 (1993), pp. 116-121

Medline

[18]

G. Holt, N. Miller, M.P. Kelly, W.J. Leach.

Retention of the patella in total knee arthroplasty for rheumatoid artritis.

Joint Bone Spine, 73 (2006), pp. 523-526

http://dx.doi.org/10.1016/j.jbspin.2005.11.017 | Medline

[19]

H. Shoji, S. Yoshino, A. Kajino.

Patellar replacement in bilateral total knee arthroplasty. A study of patients wha had rheumatoid artritis and no gross deformity of the patella.

J Bone Joint Surg (Am), 71-A (1989), pp. 853-856

[20]

A. Kajino, S. Yoshino, S. Kameyama, M. Kodha, S. Nagashima.

Comparison of the results of bilateral total knee arthroplasty with and without patellar replacement for rheumatoid arthritis. A follow-up note.

J Bone Joint Surg (Am), 79-A (1997), pp. 570-574

[21]

J.A. Feller, R.J. Bartlett, D.M. Lang.

Patellar resurfacing versus retention in total knee arthroplasty.

J Bone Joint Surg (Br), 78-B (1996), pp. 226-228

[22]

G.D. Picetti, W.A. McGann, R.B. Welch.

The patellofemoral joint after total knee arthroplasty without patellar resurfacing.

J Bone Joint Surg (Am), 72-A (1990), pp. 1379-1382

[23]

N. Helmy, C. Anglin, N.V. Greidanus, B.A. Masri.

To resurface or not to resurface the patella in total knee athroplasty.

Clin Orthop Relat Res, 466 (2008), pp. 2775-2783

http://dx.doi.org/10.1007/s11999-008-0420-3 | Medline

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