Comparison Of Total Knee Arthroplasty With And Without Patellar Replacement

[Purpose]To compare retrospectively the clinical outcome of total knee arthroplasty(TKA) with and without patellar replacement, To provide reference for clinical treatment.[Methods]From January 2013 to December 2015, 42 patients with osteoarthritis of the knee joint were treated in the Affiliated Union Hospital of Fujian Medical Universityl were evaluated postoperatively using a questionnaire, Patients were selected according to the established inclusion and exclusion criteria.Operation for the same doctor,Using the same type of total knee prosthesis(Depuy). Two groups were divided into patellar replacement group and nonreplacement group.19 knees underwent patellar replacement,23 knees underwent patellar nonreplacement. All patients were followed up after operation. The patients were scored using HSS Score for knees?Feller Score for patella?anterior knee pain using Fel ler Score and radiographs,The data were analyzed using SPSS 19.0 software.[Results]41 cases had been followed up,one cases of nonreplacement group lost to visit, Time of followed-up was 1-30 months, The average follow-up time was 13.05±7.08 months in the replacement group,follow up rate is 100.00%.The average follow-up time was 11.59±7.06 months in the nonreplacement group,follow up rate is 95.65%.The preoperative mean HSS score of patients with patellar replacement improved from 36.05±3.39 points to 84.16±7.34 points at the most recent follow-up,The preoperative mean Feller score of patients with patellar replacement improved from 13.26±1.73 points to 24.95±2.39 points at the most recent follow-up,The preoperative mean anterior knee pain score of patients with patellar replacement improved from 3.95±2.09 points to 13.16±3.42 points at the most recent follow-up,Tibiofemoral angle with patellar replacement from(170.00±5.59)° chang to(168.84±6.58)° at the most recent follow-up,Patellar ligament ratio with patellar replacement from 1.00±0.13 chang to 0.97±0.85 at the most recent follow-up,Patella suitable angle from(12.16±6.06)° chang to(9.00±3.14)° at the most recent follow-up,Patella tilt angle from(6.68±2.50)° chang to(5.26±1.24)° at the most recent follow-up.The preoperative mean HSS score of patients with patellar retention improved from 35.68±2.77 points to 83.27±8.36 points at the most recent follow-up,The preoperative mean Fel ler score of patients with patellar retention improved from 13.95±1.43 points to 24.91±2.00 points at the most recent follow-up,The preoperative mean anterior knee pain score of patients with patellar retention improved from 4.09±1.97 points to 10.23±0.49 points at the most recent follow-up.Tibiofemoral angle with patellar replacement from(172.90±5.61)° chang to(172.68±7.39)° at the most recent follow-up,Patellar ligament ratio with patellar replacement from 1.01±0.08 chang to 1.02±0.96 at the most recent follow-up,Patella suitable angle from(11.00±5.86)° chang to(8.27±3.64)° at the most recent follow-up,Patella tilt angle from(6.45±2.24)° chang to(5.27±0.77)° at the most recent follow-up.The HSS score, Feller score, knee pain score before and after operation were significantly different between the replacement group and the non replacement group(P<0.05),There were no significant differences between the both groups in scores of knee HSS?Feller scores?tibiofemoral angle?patellar ligament ratio?patella suitable angle and patella tilt angle(P>0.05),But significant differences between the both groups in anterior knee pain score(P<0.05). [Conclusion]TKA is effective to improve the function of the knee and patella and anterior knee pain patellar replacement in the TKA showed a significant effect in improving anterior knee pain,However, the long-term effect after TKA still need to be observed.