[Patella reshaping versus resurfacing in total knee arthroplasty: a prospective randomized study].
OBJECTIVE
To investigate the differences in the clinical outcome of total knee arthroplasty according to patellar reshaping or resurfacing.


METHODS
From January 2002 to December 2002, 60 patients (60 knees) undergoing primary total knee arthroplasty for the treatment of osteoarthritis were enrolled in a prospective, randomized study. All patients received the same posterior-cruciate-substituting total knee prosthetic components. Patients were randomized to the treatment with reshaping or resurfacing of the patella, and the results were followed up for a mean of 54 months (40-60 months). Evaluations consisted of the determination of a Knee Society Score, range of motion for knees, patient satisfaction, and radiographs.


RESULTS
With the numbers available for study, no significant difference was found between the knees that had patellar resurfacing and those that had patellar reshaping with regard to the overall score (P=0.12), the subscore for pain (P=0.90), and patient satisfaction (P=0.22). The results showed that the same prevalence of any anterior knee pain in two groups was 10%, and it did not represent a significant difference. The two groups showed statistical difference with regard to the total function score and range of motion.


CONCLUSIONS
It has shown that total knee arthroplasty with patella reshaping or resurfacing dramatically relieves pain and improves the function. It seems that postoperative anterior knee pain is related either to the component design or to the details of the surgical technique, rather than to whether or not the patella is resurfaced.
Liu
Zhong-tang
ZT
Department of Orthopedics, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China.
Wu
Yu-li
YL
Li
Xiao-hua
XH
Qian
Qi-rong
QR
Zhu
Yun-li
YL
Wu
Hai-shan
HS
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010329:Patella / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome