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Getting Below the Surface of the Kneecap During Total Knee Replacement Surgery

When total knee replacements became a treatment option for arthritis, surgeons questioned whether to keep or replace the kneecap (patella). To this day the debate goes on without a clear answer. In this study researchers looked at all the studies done on this topic. They covered a period from January 1966 until August 2003.

This type of review is called a meta-analysis. This type of study helps water down any strong bias one way or the other. It helps point out any findings that are the same over time. This study combined two kinds of surgery: patella replaced (resurfaced) and patella retained (unresurfaced).

Several measures were used to compare the two options. The main outcomes were number of patients who had a second operation, patellar pain or other problems, and knee function (including climbing stairs). Patient satisfaction was used, too.

The overall results show an advantage for replacing the patella during knee joint replacement. Results were better with the resurfaced patellae. Even so the authors said the information didn't lend itself to any firm conclusions. There were just too many variables to take into account.

References: R. S. Nizard, MD, PhD, et al. A Meta-Analysis of Patellar Replacement in Total Knee Arthroplasty. In Clinical Orthopaedics and Related Research. March 2005. Vol. 432. Pp. 196-203.

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