title: Secondary Patellar Resurfacing as a Rescue Procedure for Persistent Anterior Knee Pain After Primary Total Knee Arthroplasty: Do Our Patients Really Improve?
abstract: Secondary patellar resurfacing (SPR) is a procedure that can be used in patients with persistent anterior knee pain (AKP) after a primary total knee arthroplasty. The aim of our study was to analyze the clinical and functional outcomes as well as the complications of this procedure and identify predictive factors for a favorable outcome.
  
  
  
  Forty-six patients who underwent SPR for persistent AKP after primary total knee arthroplasty were retrospectively studied. The patient's mean age was 68 years (range, 36-86 years). The average follow-up time after SPR was 74 months (range, 24-197 months). Demographic data, Knee Society Score scale, range of motion, pain improvement (Visual Analogue Scale), overall satisfaction, and complications were recorded. The statistical analysis was performed using STATA tm/SE v10.
  
  
  
  There was an improvement of the Knee Society scale (from 54 ± 11 to 64 ± 16 points; P < .05). However, in 59% of the cases, there was no pain improvement, and 65% of patients were not satisfied. Four patients showed complications, and in 2 cases, reoperation was necessary. We did not find any preoperative predictive factor for a favorable outcome after SPR.
  
  
  
  Despite improvement of the Knee Society scale, many patients continue with AKP and are dissatisfied with this procedure; therefore, we do not recommend it in this clinical scenario.
authors.affiliation: Orthopaedic Department, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Ainhoa Nekane
authors.initials: AN
authors.lastname: Toro-Ibarguen
authors.affiliation: Arthroplasty Division, Orthopaedic Department, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Navarro-Arribas
authors.affiliation: Muskuloskeletal Oncology Division, Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: Juan
authors.initials: J
authors.lastname: Pretell-Mazzini
authors.affiliation: Orthopaedic Department, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Alfonso Carlos
authors.initials: AC
authors.lastname: Prada-Cañizares
authors.affiliation: Arthroplasty Division, Hospital 12 de Octubre, Complutense University of Madrid, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Jara-Sánchez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D059350:Chronic Pain / Q000601:surgery; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000601:surgery; D010329:Patella / Q000601:surgery*; D046788:Patellofemoral Pain Syndrome / Q000209:etiology / Q000601:surgery*; D017060:Patient Satisfaction; D012086:Reoperation / Q000009:adverse effects; D012189:Retrospective Studies
keywords: anterior knee pain; knee arthroplasty; patellar resurfacing; revision arthroplasty; secondary patellar resurfacing