A Single Surgeon Experience of Selective Patellar Resurfacing During Primary Total Knee Arthroplasty
Background: Routine patellar resurfacing remains controversial in primary total knee arthroplasty (TKA). This study reports the experience of a high-volume arthroplasty surgeon who stopped routinely resurfacing patellae for a 3-year period. Methods: All primary TKAs performed by a single surgeon bet...
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Elsevier
2024-12-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344124002486 |
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| author | Catelyn A. Woelfle, BA H. John Cooper, MD |
| author_facet | Catelyn A. Woelfle, BA H. John Cooper, MD |
| author_sort | Catelyn A. Woelfle, BA |
| collection | DOAJ |
| description | Background: Routine patellar resurfacing remains controversial in primary total knee arthroplasty (TKA). This study reports the experience of a high-volume arthroplasty surgeon who stopped routinely resurfacing patellae for a 3-year period. Methods: All primary TKAs performed by a single surgeon between January 2018 and September 2022 with minimum 1-year follow-up were retrospectively reviewed. Data were analyzed between cohorts—nonresurfaced and resurfaced patellae—and between phases—universal and selective resurfacing. Outcomes included reoperation, patellar complications, and patient-related outcome measure scores. Results: Five hundred four primary TKAs, with mean 24-month follow-up, were included. Patellar resurfacing was performed in 77% of the overall cohort, including 58% in the selective and 100% in the universal phases. Reoperation (7.6% vs 0.3%; P < .001) and patellar complications (8.4% vs 1.3%; P < .001) were higher in the nonresurfaced vs resurfaced cohort. Eight of the 9 reoperations in the nonresurfaced group were for secondary resurfacing, and all were female (P = .017). Mean 12-Item Short Form Health Survey Physical Health (P = .037) and Western Ontario and McMaster Universities Arthritis Index Pain scores (P = .002) were better in the resurfaced cohort. Selective resurfacing demonstrated a higher reoperation rate (3.3% vs 0.4%; P = .022) and worse Western Ontario and McMaster Universities Arthritis Index Pain (P = .026) and Knee Society Knee Functional scores (P = .042). Conclusions: Cessation of routine patellar resurfacing led to inferior clinical results and an unacceptably high early reoperation rate, specifically among women. The generalizability of these findings may be limited due to surgeon-specific factors; however, we urge caution in surgeons who consider similar changes in practice. Level of Evidence: Level III. |
| format | Article |
| id | doaj-art-5ae68281a9824f249b05d9d05db5af07 |
| institution | DOAJ |
| issn | 2352-3441 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj-art-5ae68281a9824f249b05d9d05db5af072025-08-20T02:52:25ZengElsevierArthroplasty Today2352-34412024-12-013010156310.1016/j.artd.2024.101563A Single Surgeon Experience of Selective Patellar Resurfacing During Primary Total Knee ArthroplastyCatelyn A. Woelfle, BA0H. John Cooper, MD1Department of Orthopedic Surgery, New York Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY, USACorresponding author. Department of Orthopedic Surgery, Columbia University Medical Center, 622 West 168th Street, PH 1149, New York, NY 10032, USA. Tel.: +1 914 787 2468.; Department of Orthopedic Surgery, New York Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY, USABackground: Routine patellar resurfacing remains controversial in primary total knee arthroplasty (TKA). This study reports the experience of a high-volume arthroplasty surgeon who stopped routinely resurfacing patellae for a 3-year period. Methods: All primary TKAs performed by a single surgeon between January 2018 and September 2022 with minimum 1-year follow-up were retrospectively reviewed. Data were analyzed between cohorts—nonresurfaced and resurfaced patellae—and between phases—universal and selective resurfacing. Outcomes included reoperation, patellar complications, and patient-related outcome measure scores. Results: Five hundred four primary TKAs, with mean 24-month follow-up, were included. Patellar resurfacing was performed in 77% of the overall cohort, including 58% in the selective and 100% in the universal phases. Reoperation (7.6% vs 0.3%; P < .001) and patellar complications (8.4% vs 1.3%; P < .001) were higher in the nonresurfaced vs resurfaced cohort. Eight of the 9 reoperations in the nonresurfaced group were for secondary resurfacing, and all were female (P = .017). Mean 12-Item Short Form Health Survey Physical Health (P = .037) and Western Ontario and McMaster Universities Arthritis Index Pain scores (P = .002) were better in the resurfaced cohort. Selective resurfacing demonstrated a higher reoperation rate (3.3% vs 0.4%; P = .022) and worse Western Ontario and McMaster Universities Arthritis Index Pain (P = .026) and Knee Society Knee Functional scores (P = .042). Conclusions: Cessation of routine patellar resurfacing led to inferior clinical results and an unacceptably high early reoperation rate, specifically among women. The generalizability of these findings may be limited due to surgeon-specific factors; however, we urge caution in surgeons who consider similar changes in practice. Level of Evidence: Level III.http://www.sciencedirect.com/science/article/pii/S2352344124002486Total knee arthroplasty (TKA)Revision total Knee arthroplastyPatellar resurfacingReoperationSecondary resurfacing |
| spellingShingle | Catelyn A. Woelfle, BA H. John Cooper, MD A Single Surgeon Experience of Selective Patellar Resurfacing During Primary Total Knee Arthroplasty Arthroplasty Today Total knee arthroplasty (TKA) Revision total Knee arthroplasty Patellar resurfacing Reoperation Secondary resurfacing |
| title | A Single Surgeon Experience of Selective Patellar Resurfacing During Primary Total Knee Arthroplasty |
| title_full | A Single Surgeon Experience of Selective Patellar Resurfacing During Primary Total Knee Arthroplasty |
| title_fullStr | A Single Surgeon Experience of Selective Patellar Resurfacing During Primary Total Knee Arthroplasty |
| title_full_unstemmed | A Single Surgeon Experience of Selective Patellar Resurfacing During Primary Total Knee Arthroplasty |
| title_short | A Single Surgeon Experience of Selective Patellar Resurfacing During Primary Total Knee Arthroplasty |
| title_sort | single surgeon experience of selective patellar resurfacing during primary total knee arthroplasty |
| topic | Total knee arthroplasty (TKA) Revision total Knee arthroplasty Patellar resurfacing Reoperation Secondary resurfacing |
| url | http://www.sciencedirect.com/science/article/pii/S2352344124002486 |
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