Total knee arthroplasty without patellar resurfacing

Total knee arthroplasty (TKA) without patellar resurfacing by using cemented surface-type prosthesis (Okayama University PCL-R type) was reviewed over 1 year (average 3.3 years). They were 101 cases (137 rheumatoid and 41 osteoarthritic knees). About 15% of rheumatoid cases had mild patellofemoral(P-F) joint pain, and 24.4% of osteoarthritic (OA) cases also complained of mild pain around the patella at standing up and stair climbing, but the pain gradually reduced after 3 years in OA. In such patients with P-F joint pain, there is a tendency of lateral shifting and lateral lilting of the patella, which means incongruity of the P-F joint. Remodeling of the retropatellar surface can be seen within 2-3 years postoperatively, and such a change can reduce the P-F joint pain, especially in OA. It was concluded that P-F pain can be very slight and not hazardous for the patients daily life, if good alignment of the P-F joint is obtained during the operation.