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Total knee replacement with and without patellar resurfacing: a prospective, randomised trial using the profix total knee system.

Authors
  • Smith, A J1
  • Wood, D J
  • Li, M-G
  • 1 School of Surgery and Pathology (Orthopaedics) University of Western Australia, Gate 3, Verdun Street, Nedlands, Western Australia 6009, Australia. [email protected] , (Australia)
Type
Published Article
Journal
Journal of Bone and Joint Surgery - British Volume
Publisher
British Editorial Society of Bone and Joint Surgery
Publication Date
Jan 01, 2008
Volume
90
Issue
1
Pages
43–49
Identifiers
PMID: 18160498
Source
Medline
License
Unknown

Abstract

We have examined the differences in clinical outcome of total knee replacement (TKR) with and without patellar resurfacing in a prospective, randomised study of 181 osteoarthritic knees in 142 patients using the Profix total knee system which has a femoral component with features considered to be anatomical and a domed patellar implant. The procedures were carried out between February 1998 and November 2002. A total of 159 TKRs in 142 patients were available for review at a mean of four years (3 to 7). The patients and the clinical evaluator were blinded in this prospective study. Evaluation was undertaken annually by an independent observer using the knee pain scale and the Knee Society clinical rating system. Specific evaluation of anterior knee pain, stair-climbing and rising from a seated to a standing position was also undertaken. No benefit was shown of TKR with patellar resurfacing over that without resurfacing with respect to any of the measured outcomes. In 22 of 73 knees (30.1%) with and 18 of 86 knees (20.9%) without patellar resurfacing there was some degree of anterior knee pain (p = 0.183). No revisions related to the patellofemoral joint were performed in either group. Only one TKR in each group underwent a re-operation related to the patellofemoral joint. A significant association between knee flexion contracture and anterior knee pain was observed in those knees with patellar resurfacing (p = 0.006).

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