Patellar management during total knee arthroplasty: a review

Abstract

■ The optimal management of the patella during total knee arthroplasty (TKA) remains controversial and surgeons tend to approach the patella with one of three general mindsets: always resurface the patella, never resurface the patella, or selectively resurface the patella based on specific patient or patellar criteria. ■ Studies comparing resurfacing and non-resurfacing of the patella during TKA have reported inconsistent and contradictory findings. ■ When resurfacing the patella is chosen, there are a number of available patellar component designs, materials, and techniques for cutting and fixation. ■ When patellar non-resurfacing is chosen, several alternatives are available, including patellar denervation, lateral retinacular release, and patelloplasty. Surgeons may choose to perform any of these alone, or together in some combination. ■ Prospective randomized studies are needed to better understand which patellar management techniques contribute to superior postoperative outcomes. Until then, this remains a controversial topic, and options for patellar management will need to be weighed on an individual basis per patient.