Clinical and functional outcomes following primary total knee arthroplasty with Patellar Non-resurfacing

Abstract

Background and Objective : Total knee replacement surgery is considered as a treatment of choice in patients with advanced arthritis, especially in patients where conservative treatment have been failed and functional motor disability hinders the patient from performing his daily activities .

The aim of the study is to study the clinical and functional outcomes of the primary knee arthroplasty surgery without patellar resurfacing at Al Assad University Hospital in Damascus.

Materials & methods: A consecutive series of 66 cases of primary total knee replacement without patellar resurfacing, (42 patients) performed over a period from May 2014 to February 2016 and a minimum follow-up period of one year. The cases were evaluated depending on the Range Of Motion  (ROM)  and (KSS) knee society score standard . This study was conducted in the Division of Joint Surgery at Al Assad University Hospital in Damascus after reviewing the files of patients. 24 cases were bilateral, 11 were right knee and 7 were left knee .Results: There was a marked improvement in patient function, 37 patients were in excellent results and 5 patients were in good results , not a bad results. During an average follow-up period of 2.5 years, clinical outcomes on the KSS scale were improved from about 28.28 preoperatively to approximately 94.23 postoperatively, and in the functional outcomes there was improvement from about 41.67 to about 87.33.We had 3 cases of superficial wound infection that were later cured by follow-up with intravenous antibiotics and bandages, and no deep infection, one case of DVT for a patient with a cardiac history, no loosning or revision, no fracture or infarction of patella, 4 patients with mild anterior knee pain relax on the medication at the end of the follow-up period.Conclusion: In about 42 patients with advanced arthritis, pain and motor disability were the most common symptoms, with inability to flex the knee, difficulty in practicing daily activities, and various degrees of knee deformities such as varus deformity and fixed flexion deformity where they underwent a total knee replacement without patellar resurfacing and the results were good, Therefore, we consider that the non-use of the patellar component is the preferred form of management and reduce the incidence of complications related to the patellar component.