The role of patelloplasty in total knee arthroplasty.
BACKGROUND
Anterior knee pain (AKP) is a frequent complication after total knee arthroplasty (TKA). Patelloplasty, defined as reshaping the patella for optimal tracking in the trochlea, has been proposed to reduce the rate of this complication in patellar retaining implants. Aim of this study was to analyze the available literature regarding the outcomes of patelloplasty and to assess its methodological quality.


METHODS
A comprehensive review of the English literature was performed using the keywords "total knee arthroplasty", "patelloplasty" and "patellaplasty" with no limit regarding the year of publication. All the selected articles were evaluated with the Coleman score.


RESULTS
Seven full text articles were retrieved. The initial cohort included 461 knees in the study groups and 465 in the control groups. At an average FU of 70.6 months 447 knees were reviewed in the study group and 447 in the control groups. The global rate of AKP after patelloplasty was 11.3 % which compared to 7.9 % in the patella resurfacing control group. No signs of specific patellar complications due to patelloplasty were reported. Average Coleman score was 66.9.


CONCLUSIONS
Most of the literature has barely sufficient methodological quality. Patelloplasty aims at reducing patellar thickness and improve its tracking with TKA. This procedure is a safe and easy option with no reported adverse effects. In the included studies, outcome seemed to be superior in comparison with isolated osteophyte removal and denervation with a lower rate of AKP. The included studies, however, report a lower rate of AKP following TKA with patellar resurfacing. Patelloplasty may have the potential to improve the outcome of patellar retaining implants.


METHODS
4, systematic review.
Casa di Cura Villa Betania, Via Piccolomini 27, 00165, Rome, Italy. simone.cerciello@me.com.|Marrelli Hospital, Via Gioacchino da Fiore, 0962, Crotone, Italy. simone.cerciello@me.com.
Simone
S
Cerciello
Albert Trillat Center, Lyon North University Hospital, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France.
Jonathan
J
Robin
Albert Trillat Center, Lyon North University Hospital, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France.
Sébastien
S
Lustig
Department of Geriatric Neurosciences and Orthopaedics, Catholic University, Largo Francesco Vito 1, 00168, Rome, Italy.
Giulio
G
Maccauro
Center for Orthopaedics and Trauma Surgery, University Hospital, Baldingerstrasse, 35043, Marburg, Germany.
Thomas J
TJ
Heyse
Albert Trillat Center, Lyon North University Hospital, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France.
Philippe
P
Neyret
D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000601:surgery; D010329:Patella / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
Anterior knee pain; Patellaplasty; Patellar retaining; Patelloplasty; Total knee arthroplasty