title: Retention of the patella in total knee arthroplasty for rheumatoid arthritis.
abstract: OBJECTIVE
  To determine whether retention of the native patella during total knee arthroplasty is appropriate in patients with rheumatoid arthritis.
  
  
  METHODS
  All patients undergoing total knee arthroplasty with a diagnosis of rheumatoid arthritis were identified between January 1997 and December 2000. Subsequently, each individual underwent both radiological and clinical assessments at a designated follow-up clinic.
  
  
  RESULTS
  A total of 30 total knee arthroplasties were studied in 28 patients. Twenty-six patients (93%) were female with a mean age of 74.7 years (range 60-83 years). The average post-operative interval was 59.4 months (range 46-82 months). All individuals were noted to have satisfactory patellar tracking and bone stock at the time of surgery. No patient subsequently underwent revision surgery during follow-up and no episodes of implant sepsis were identified. The mean Patellar Score at final follow-up was 26.2 (range 22-30) with an average anterior knee pain score of 14.2 (range 10-15). The mean Oxford Knee Score was 18.7 (range 16-23) with a mean pain score component of 5.9. Patients were finally assessed with respect to the Knee Society Score. The mean Knee Score was 83.8 (range 71-96) with a mean Function Score of 79.7 (range 40-90).
  
  
  CONCLUSIONS
  By retaining the native patella we were still able to obtain highly satisfactory medium-term results in terms of pain relief and function. In addition, the potential complications associated with prosthetic replacement of the patella were avoided.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Western Infirmary, Dumbarton Road, Glasgow, Scotland, G11 6NT. graemeholt@btinternet.com
authors.forename: G
authors.initials: G
authors.lastname: Holt
authors.forename: N
authors.initials: N
authors.lastname: Miller
authors.forename: M P
authors.initials: MP
authors.lastname: Kelly
authors.forename: W J
authors.initials: WJ
authors.lastname: Leach
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome