Patellar Resurfacing Or Not In Total Knee Arthroplasty: A Systematic Review

Objective To evaluate the effects of total knee arthroplasty performed with and without patellar resurfacing using the method of Cochrane systematic review.Method:All randomized controlled trials comparing total knee arthroplasty performed with and without patellar resurfacing were retrieved and included. The risk of bias and the quality of the trials were assessed. The relevant data were exacted and a Meta-analysis was performed.Result:Fourteen trials assessing 1223 knees were eligible. There was no significant difference between the compared arms in reoperation rate when we examined trials in which patients had been followed for less than four years (risk ratio RR1.45,95%CI 0.45-4.72); whereas the reoperation rate of the nonresurfaced group was significantly greater than resurfaced group when the follow up period more than 4 years. There were no significant differences between two arms in patient satisfaction, knee score and knee function score but affirmative can be identified in postoperative anterior knee pain.Conclusion:The available evidence indicates that the medium-term and long-term rate of reoperations in total knee arthroplasty performed with patellar resurfacing was lower than that without patellar resurfacing. There was not enough evidence showing obvious advantage in postoperative anterior knee pain patient satisfaction, knee score and knee function score in any arms. Limited by the deficiency in included studies, carefully designed randomized trials are required to strengthen this claim.