title: Patellar resurfacing versus nonresurfacing in total knee arthroplasty: a meta-analysis of randomised controlled trials.
abstract: OBJECTIVE
  Patella resurfacing or nonresurfacing in total knee arthroplasty remains controversial. The aim of this study was to evaluate the efficacy of patellar resurfacing through an evaluation of the current literature.
  
  
  METHODS
  We carried out a meta-analysis of randomised controlled trials comparing total knee arthroplasties performed with and without patellar resurfacing. Outcomes of reoperation, anterior knee pain and knee scores were analysed.
  
  
  RESULTS
  Fourteen trials assessing 1,725 knees were eligible. The absolute risk of reoperation was reduced by 4 % (95 % confidence interval, 2-6 %) in the patellar resurfacing arm (between-study heterogeneity, P = 0.05, I(2) = 42 %), implying that one would have to resurface 25 patellae (95 % confidence interval, 17-50 patellae) in order to prevent one reoperation. There was no difference between the two groups in terms of anterior knee pain, knee pain score, Knee Society score and knee function score. But in the studies followed up for a mean time of not less than five years, a difference was found between the two arms in Knee Society scores (RR = 2.14, 95 % confidence interval, 0.76-3.52; P = 0.002).
  
  
  CONCLUSIONS
  The available evidence indicates that patellar resurfacing reduces the risk of reoperation after total knee arthroplasty. Patellar resurfacing patients may make a difference in long-term follow-up (five or more 5 years) of Knee Society scores. In other aspects, the benefit of patellar resurfacing is limited. Additionally, more carefully and scientifically designed randomised controlled trials are required to further prove the claim.
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Tenth People's Hospital / Tenth People's Hospital of Tongji University, Shanghai, China. magaer@126.com
authors.forename: Kai
authors.initials: K
authors.lastname: Chen
authors.forename: Guodong
authors.initials: G
authors.lastname: Li
authors.forename: Dong
authors.initials: D
authors.lastname: Fu
authors.forename: Chaoqun
authors.initials: C
authors.lastname: Yuan
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhang
authors.forename: Zhengdong
authors.initials: Z
authors.lastname: Cai
mesh_terms: D018771:Arthralgia / Q000453:epidemiology; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000502:physiology / Q000601:surgery*; D007720:Knee Prosthesis; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010329:Patella / Q000601:surgery*; D012086:Reoperation; D012307:Risk Factors; D016896:Treatment Outcome