title: Patellar resurfacing complications in total knee arthroplasty.
abstract: OBJECTIVE
  The ideal management of the patella during total knee arthroplasty (TKA) is still controversial. Patellar retention is generally associated with an increased rate of anterior knee pain; however, patient satisfaction is similar in cases of replacement or retention. When the patella is replaced, potential severe complications can occur. Aim of this study was to retrospectively review results of a continuous series of patients having been treated with TKA and patella resurfacing.
  
  
  METHODS
  The charts of 1,600 consecutive total knee prostheses were analysed to evaluate the rate of patellar resurfacing. All implants were posterior stabilized; 310 patients having received a patellar replacement were reviewed at follow-up (FU) examination. Complete physical examination as well as administration of the Hospital for Special Surgery (HSS) score was performed. X-rays analysis included weightbearing anteroposterior (AP) and lateral views of the injured knee and bilateral skyline views at 30° flexion.
  
  
  RESULTS
  Two hundred and eighty patients were available for clinical and imaging investigation at an average FU of 96 (58-144) months. Mean age at the time of surgery was 70 (62-80) years. Mean HSS score was 85.9 ± 7.6. The overall rate of patellofemoral complications was 7% (19 cases); 13 patients claimed anterior knee pain, five had symptomatic patellar maltracking and one had patellar component loosening.
  
  
  CONCLUSIONS
  Our data are in accordance with those available in the literature. Recent meta-analyses demonstrated lower risk of re-operation after patellar resurfacing. However, when complications of the resurfaced patella occur, they can be potentially catastrophic events.
authors.affiliation: Department of Medicine, Orthopaedic Clinic, Molise University, Via de Sanctis 1, 00168, Campobasso, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Schiavone Panni
authors.forename: Simone
authors.initials: S
authors.lastname: Cerciello
authors.forename: Chiara
authors.initials: C
authors.lastname: Del Regno
authors.forename: Alessandro
authors.initials: A
authors.lastname: Felici
authors.forename: Michele
authors.initials: M
authors.lastname: Vasso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000453:epidemiology; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology; D006801:Humans; D007592:Joint Diseases / Q000601:surgery; D007719:Knee Joint / Q000601:surgery*; D008875:Middle Aged; D010329:Patella / Q000293:injuries* / Q000601:surgery*; D011475:Prosthesis Failure / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors