Patelloplasty without resurfacing of the patella in total knee replacement in patients without severe patellofemoral osteoarthritis

Purpose
The aim of this prospective study was to assess the clinical results of nonresurfacing patelloplasty in total knee arthroplasty for osteoarthritis in middle-aged active patients with less erosion of the patellar articular cartilage, based on the hypothesis that patellar denervation provides pain relief and improvement in clinical results.
Patients and methods
The study was conducted during the period between June 2009 and December 2013 on 59 knees of 55 patients (four bilateral) who met the criteria. The procedure was performed in three hospitals using the same technique. We used the Knee Society Knee Scoring System for overall assessment of patients’ knees. For patellofemoral status, we used the Outerbridge Grading System and we used the scale of Stern and Insall to assess anterior knee pain.
Results
The mean Knee Society Scores for the patients were improved from 15.2 preoperatively to 91.3 at postoperative follow-up. Fifty-one patients could use stairs without symptoms or with mild pain (grades 0 and I), and four patients were unable to use stairs due to severe symptoms (grade II); one of them was able to use stairs after 2 years of follow-up.
Conclusion
The results of patelloplasty without resurfacing of the patella in selected patients, clinically, radiologically, and intraoperatively are comparable to the results of patellar resurfacing, but with fewer hazards and complications.