title: Three dimensional CT-based virtual patellar resection in female patients undergoing total knee replacement: a comparison between tendon and subchondral method.
abstract: BACKGROUND
  Due to its small size, variable shape, and lack of distinct anatomical landmarks, osteoarthritic knees make a precise patellar resection extremely difficult.
  
  
  METHODS
  We performed virtual patellar resection with digital software using three dimensional computed tomography scans of knees from 49 patients who underwent primary total knee replacement at our hospital. We compared 2 commonly used resection methods, the tendon method (TM) and the subchondral method, to determine an ideal resection plane with respect to the symmetry and thickness of the patellar remnant.
  
  
  RESULTS
  The TM gave a thicker resected patella, and a less oval cut surface shape, which gives better coverage for a domed prosthesis. Both methods, however, gave a symmetric resection both superior-inferiorly, as well as mediolaterally.
  
  
  CONCLUSIONS
  Although TM appears statistically better with respect to the thickness and cut surface shape, only further intraoperative studies with long-term clinical follow-up may provide us with the most appropriate patellar resection method.
authors.affiliation: Division of Arthroplasty, Department of Orthopaedics, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Do Young
authors.initials: DY
authors.lastname: Park
authors.forename: Hyung-Min
authors.initials: HM
authors.lastname: Ji
authors.forename: Kyu-Sung
authors.initials: KS
authors.lastname: Kwak
authors.forename: Surej Gopinathan
authors.initials: SG
authors.lastname: Nair
authors.forename: Ye-Yeon
authors.initials: YY
authors.lastname: Won
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008875:Middle Aged; D010329:Patella / Q000033:anatomy & histology* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*