Abstract
1346 Primary TKR’s were evaluated. In keeping with the principle of Insall all patellas were resurfaced with the only exclusion being a previous patellectomy or excessive patella erosion.
Most TKR were of posterior cruciate substituting devices (IB11 (56.9%) or Nexgen LPS (42.3%)). The reason for operation was OA (94.5%), RA (2.9%), and others 2.6%. Most knees were in varus (68.5%), 17% were in valgus, and 14.5% were in neutral alignment.
The method of preparing the patella and extensor mechanism was as follows: A total fat pad excision was performed, debulking the patella thickness of 1mm. The patella component was placed medially and superiorly, a peri-patella synovectomy was performed, and a release of the lateral patella femoral ligaments was done. A lateral release was performed in 17.5% of patients.
Follow up ranges from 9 months to 15 years. Reoperation for patella problems was necessary in only 5 patients (0.37%). There was 1 case of patella subluxation, 1 case of persistent anterior knee pain, and 3 patients with a patella clunk (in IB 11 knees only)
In our hands this approach has led to excellent long term results without some of the potential complications described in the literature and warrants continued use of routine patella resurfacing when doing TKR.
Correspondence should be addressed to: Léana Fourie, CEO SAOA, PO Box 12918, Brandhof 9324 South Africa.
