>> The optimal management of the patella during total knee arthroplasty (TKA) remains a controversial topic with no consensus. >> Patellar management techniques during TKA include patellar retention or resurfacing with or without patellaplasty, as well as circumferential denervation and partial lateral facetectomy (PLF). >> Special considerations such as patient age, etiology of disease, implant design, and surgeon preference should be accounted for when determining optimal management. >> We recommend that most patellae be circumferentially denervated, regardless of whether they are resurfaced, as the potential benefits outweigh the small associated risks. >> Evidence demonstrates improved functional outcomes with the addition of PLF to nonresurfaced patellae. There is currently a paucity of evidence of this technique with respect to resurfaced patellae. >> Patellar resurfacing adds additional costs and health-care resources that should be considered in the decision-making process.
机构:
Case Western Reserve Univ, Sch Med, Cleveland, OH USACase Western Reserve Univ, Sch Med, Cleveland, OH USA
McConaghy, Kara
Derr, Tabitha
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机构:
Drexel Univ, Sch Biomed Engn Sci & Hlth Syst, Implant Res Core, Philadelphia, PA 19104 USACase Western Reserve Univ, Sch Med, Cleveland, OH USA
Derr, Tabitha
Molloy, Robert M.
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机构:
Cleveland Clin, Dept Orthoped Surg, Cleveland, OH 19104 USACase Western Reserve Univ, Sch Med, Cleveland, OH USA
Molloy, Robert M.
Klika, Alison K.
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机构:
Cleveland Clin, Dept Orthoped Surg, Cleveland, OH 19104 USACase Western Reserve Univ, Sch Med, Cleveland, OH USA
Klika, Alison K.
Kurtz, Steven
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机构:
Drexel Univ, Sch Biomed Engn Sci & Hlth Syst, Implant Res Core, Philadelphia, PA 19104 USA
Exponent, Philadelphia, PA USACase Western Reserve Univ, Sch Med, Cleveland, OH USA
Kurtz, Steven
Piuzzi, Nicolas S.
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Cleveland Clin, Dept Orthoped Surg, Cleveland, OH 19104 USACase Western Reserve Univ, Sch Med, Cleveland, OH USA