title: Patellar resurfacing as a second stage procedure for persistent anterior knee pain after primary total knee arthroplasty.
abstract: OBJECTIVE
  Knee pain after total knee arthroplasty may be caused by an unresurfaced patella. Secondary isolated resurfacing of the previously unresurfaced patella in total knee arthroplasty remains controversial. The aim of this retrospective study was to evaluate the outcome after patellar resurfacing as a second stage procedure.
  
  
  METHODS
  The study included 22 patients (13 female/nine male) who underwent resurfacing of the patella with a mean follow-up of 61.8 ± 39.2 months. The mean age of the patients was 60 ± 9.7 years at the time of operation. The average period between total knee arthroplasty and patellar resurfacing was 26.3 ± 15.2 months. The patient's subjective satisfaction was assessed by a custom-made questionnaire.
  
  
  RESULTS
  The mean Knee Society Score improved significantly from 60.1 ± 8.3 to 77.0 ± 6.3 (p = 0.0063). The mean functional score also improved significantly from 42.7 ± 2.3 to 60.2 ± 3.9 (p = 0.001). Three patients (13.6%) needed further operative revision.
  
  
  CONCLUSIONS
  Although clinical scores showed significant improvement some patients continued to have pain and remained dissatisfied without detecting a specific reason. Further studies are needed to better elucidate the benefit of patellar resurfacing as second stage procedure.
authors.affiliation: Orthopaedic and Tumour Orthopaedic, University Hospital Münster, Münster, Germany. kraj@gmx.net
authors.forename: Kiriakos
authors.initials: K
authors.lastname: Daniilidis
authors.forename: Bjoern
authors.initials: B
authors.lastname: Vogt
authors.forename: Georg
authors.initials: G
authors.lastname: Gosheger
authors.forename: Marcel
authors.initials: M
authors.lastname: Henrichs
authors.forename: Ralf
authors.initials: R
authors.lastname: Dieckmann
authors.forename: Dino
authors.initials: D
authors.lastname: Schulz
authors.forename: Steffen
authors.initials: S
authors.lastname: Hoell
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D010329:Patella / Q000601:surgery*; D017060:Patient Satisfaction; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies