title: Comparison of patellar resurfacing versus preservation in high flexion total knee arthroplasty.
abstract: OBJECTIVE
  Recently, high flexion design total knee arthroplasty (TKA) has been introduced to improve clinical outcomes. The purpose of this study is to compare the midterm outcomes between patellar resurfacing (PR) and patellar preservation (PP) in high flexion TKA.
  
  
  METHODS
  A total of 373 knees of primary TKAs were performed using high flexion design, 339 knees involved PR group and 34 knees involved PP group. After applying exclusion criteria, 1:3 matching was performed by the matching criteria. After matching, 69 knees in PR group and 23 knees in PP group remained. Radiographic outcomes, clinical outcomes, patients' satisfaction, ability and pain related to the high flexion activities were also evaluated.
  
  
  RESULTS
  There was no significant difference in radiograph measurements, KS function score and WOMAC score (n.s). However, PR group showed better outcomes in KS knee score (P = 0.001) and HSS score (P = 0.03). There was no significant difference in postoperative satisfaction and ability of high flexion activities between the groups, but the pain at the high flexion activities in PP group was worse than that in PR group.
  
  
  CONCLUSIONS
  In high flexion design of TKA, PR resulted in better midterm outcomes in regard to KS knee score, HSS score and knee pain related to the high flexion activities. The selective PR is recommended when performing primary TKA with high flexion design.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 110-744, Korea.
authors.forename: Seong Hwan
authors.initials: SH
authors.lastname: Kim
authors.forename: Sahnghoon
authors.initials: S
authors.lastname: Lee
authors.forename: Du Hyun
authors.initials: du H
authors.lastname: Ro
authors.forename: Yool
authors.initials: Y
authors.lastname: Cho
authors.forename: Young Min
authors.initials: YM
authors.lastname: Lee
authors.forename: Kee Yun
authors.initials: KY
authors.lastname: Chung
authors.forename: Myung Chul
authors.initials: MC
authors.lastname: Lee
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D010147:Pain Measurement; D010329:Patella / Q000601:surgery*; D017060:Patient Satisfaction; D012189:Retrospective Studies