title: The efficacy of patellar decompression for improving anterior knee pain following total knee arthroplasty without patellar resurfacing.
abstract: BACKGROUND
  Anterior knee pain remains common following total knee arthroplasty (TKA). In this study, we evaluated the efficacy of patellar decompression via drilling for the treatment of anterior knee pain following TKA without patellar resurfacing.
  
  
  METHODS
  A prospective cohort study was performed in 271 consecutive patients who underwent primary total knee replacement with patellar decompression (study group, n = 131) or without decompression (control group, n = 140). The patients were assessed according to the Knee Society rating, clinical anterior knee pain score, and British Orthopaedic Association patient-satisfaction score in each group. Each assessment was performed without the examiner knowing whether the patella had been decompressed. Radiographic evaluations were also performed according to the Knee Society scoring system for functional activity and our own severity grade system for patellofemoral articular change.
  
  
  RESULTS
  There were no adverse events following patellar decompression. The overall prevalence of anterior knee pain was not significantly different between groups (p = 0.71). However, patients presenting pain over grade II after the operation in the study group were statistically low (p = 0.01). The overall postoperative knee scores were higher in the study group, but there were no significant differences between groups (p = 0.0731). Analyses of the radiographs revealed similar postoperative outcomes in both groups of knees.
  
  
  CONCLUSIONS
  As we observed significantly lower rates of anterior knee pain and no patellar complications following patellar decompression via drilling in TKA without patellar resurfacing, we recommend performing patellar decompression in cases of total knee replacement without patellar resurfacing.
authors: Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam, Republic of Korea.
authors: Gun Woo
authors: GW
authors: Lee
authors: Sun-Mi
authors: SM
authors: Lee
authors: Soo-Jin
authors: SJ
authors: Jang
authors: Jung-Hwan
authors: JH
authors: Son
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000209:etiology / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010329:Patella / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome