title: Revision of the patella with deficient bone using a biconvex component.
abstract: Revision surgery on a failed patellar component can be difficult because of deficient residual bone that may compromise the functional outcome of the revision. We reviewed 20 knees in 20 patients in whom the residual patellar bone was less than 10 mm at the time of revision and used the Genesis Biconvex Patella implant to reconstruct the patella. The patients were followed up for an average of 34 months (range, 24-65 months), and were followed up clinically and radiographically by Knee Society criteria. Patellar revisions and complications were noted and standard radiographic studies to ascertain radiolucent lines and patella/patellar component thickness were evaluated. The Knee Society Scores improved from an average of 45 points to 89 points. Function scores improved from an average of 47 points to 65 points. None of the patients has required revision surgery and no patellar fractures have been seen. Radiographs showed complete lucencies at the cement-bone interface in two knees. The mean residual central patella bone thickness was 6.5 mm and the average postoperative composite thickness was 14.5 mm. The data indicate that the use of the Genesis Biconvex Patella implant is a satisfactory method of treating revision of the patella when there is major bone deficiency.
  
  
  METHODS
  Retrospective study, Level IV-1 (case study). See the Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH 44106, USA.
authors.forename: Conjeevaram B
authors.initials: CB
authors.lastname: Maheshwer
authors.forename: Erika
authors.initials: E
authors.lastname: Mitchell
authors.forename: Matthew
authors.initials: M
authors.lastname: Kraay
authors.forename: Victor M
authors.initials: VM
authors.lastname: Goldberg
mesh_terms: D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000000981:diagnostic imaging / Q000601:surgery*; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies