Patella resurfacing during total knee arthroplasty is cost-effective and has lower re-operation rates compared to non-resurfacing
Abstract Background The decision to resurface the patella as part of total knee arthroplasty may be influenced by the surgeon’s preference, education, training, tradition and geographic location. Advocates for non-resurfacing or selectively resurfacing may claim no difference in patient reported out...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02295-8 |
| _version_ | 1811186981501140992 |
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| author | Thomas Parsons Talal Al-Jabri Nick D. Clement Nicola Maffulli Deiary F. Kader |
| author_facet | Thomas Parsons Talal Al-Jabri Nick D. Clement Nicola Maffulli Deiary F. Kader |
| author_sort | Thomas Parsons |
| collection | DOAJ |
| description | Abstract Background The decision to resurface the patella as part of total knee arthroplasty may be influenced by the surgeon’s preference, education, training, tradition and geographic location. Advocates for non-resurfacing or selectively resurfacing may claim no difference in patient reported outcomes, and that resurfacing is associated with increased risks such as extensor mechanism injury or malalignment, problems with the design of the patella component and technical issues intraoperatively. Aims To critically examine factors that should be considered in addition to patient reported outcomes in the decision process of resurfacing or non-resurfacing of the patella in total knee arthroplasty. Method A comprehensive literature search was conducted to identify factors that may influence decision making in addition to knee specific patient reported outcome measures such as surgical risks, patient quality of life, procedure cost, re-operation rate, implant design, surgeons learning curve and the fate of remaining cartilage in native patellae. Results Patient-reported outcomes are equivocal for resurfacing and non-resurfacing. Critical analysis of the available literature suggests that the complications of resurfacing the patella are historic, which is now lower with improved implant design and surgical technique. Routine resurfacing was cost-effective in the long term (potential saving £104 per case) and has lower rates of revision (absolute risk reduction 4%). Finally, surgical judgment in selective resurfacing was prone to errors. Conclusion Patella resurfacing and non-resurfacing had similar patient-reported outcomes. However, patella resurfacing was cost-effective and was associated with a lower rate of re-operation compared to non-resurfacing. |
| first_indexed | 2024-04-11T13:54:24Z |
| format | Article |
| id | doaj.art-ef36f8f156314ad8a2eb08ddda4ff3ef |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:54:24Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-ef36f8f156314ad8a2eb08ddda4ff3ef2022-12-22T04:20:25ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-03-011611910.1186/s13018-021-02295-8Patella resurfacing during total knee arthroplasty is cost-effective and has lower re-operation rates compared to non-resurfacingThomas Parsons0Talal Al-Jabri1Nick D. Clement2Nicola Maffulli3Deiary F. Kader4South West London Elective Orthopaedic Centre, Denbies Wing, Epsom General HospitalDepartment of Surgery and Cancer, Imperial College LondonSouth West London Elective Orthopaedic Centre, Denbies Wing, Epsom General HospitalDepartment of Medicine, Surgery and Dentistry, University of SalernoSouth West London Elective Orthopaedic Centre, Denbies Wing, Epsom General HospitalAbstract Background The decision to resurface the patella as part of total knee arthroplasty may be influenced by the surgeon’s preference, education, training, tradition and geographic location. Advocates for non-resurfacing or selectively resurfacing may claim no difference in patient reported outcomes, and that resurfacing is associated with increased risks such as extensor mechanism injury or malalignment, problems with the design of the patella component and technical issues intraoperatively. Aims To critically examine factors that should be considered in addition to patient reported outcomes in the decision process of resurfacing or non-resurfacing of the patella in total knee arthroplasty. Method A comprehensive literature search was conducted to identify factors that may influence decision making in addition to knee specific patient reported outcome measures such as surgical risks, patient quality of life, procedure cost, re-operation rate, implant design, surgeons learning curve and the fate of remaining cartilage in native patellae. Results Patient-reported outcomes are equivocal for resurfacing and non-resurfacing. Critical analysis of the available literature suggests that the complications of resurfacing the patella are historic, which is now lower with improved implant design and surgical technique. Routine resurfacing was cost-effective in the long term (potential saving £104 per case) and has lower rates of revision (absolute risk reduction 4%). Finally, surgical judgment in selective resurfacing was prone to errors. Conclusion Patella resurfacing and non-resurfacing had similar patient-reported outcomes. However, patella resurfacing was cost-effective and was associated with a lower rate of re-operation compared to non-resurfacing.https://doi.org/10.1186/s13018-021-02295-8ArthroplastyPatellaKnee replacementResurfacing |
| spellingShingle | Thomas Parsons Talal Al-Jabri Nick D. Clement Nicola Maffulli Deiary F. Kader Patella resurfacing during total knee arthroplasty is cost-effective and has lower re-operation rates compared to non-resurfacing Journal of Orthopaedic Surgery and Research Arthroplasty Patella Knee replacement Resurfacing |
| title | Patella resurfacing during total knee arthroplasty is cost-effective and has lower re-operation rates compared to non-resurfacing |
| title_full | Patella resurfacing during total knee arthroplasty is cost-effective and has lower re-operation rates compared to non-resurfacing |
| title_fullStr | Patella resurfacing during total knee arthroplasty is cost-effective and has lower re-operation rates compared to non-resurfacing |
| title_full_unstemmed | Patella resurfacing during total knee arthroplasty is cost-effective and has lower re-operation rates compared to non-resurfacing |
| title_short | Patella resurfacing during total knee arthroplasty is cost-effective and has lower re-operation rates compared to non-resurfacing |
| title_sort | patella resurfacing during total knee arthroplasty is cost effective and has lower re operation rates compared to non resurfacing |
| topic | Arthroplasty Patella Knee replacement Resurfacing |
| url | https://doi.org/10.1186/s13018-021-02295-8 |
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