Patellar resurfacing versus no resurfacing in two-stage revision of infected total knee arthroplasty

Cartilage debridement and staged reimplantation are the most common treatments for infected total knee arthroplasty (TKA). Very few studies have focused on the management of primarily non-resurfaced patellae in infected TKA. The purpose of this study was to compare the outcomes of patellar resurfacing and non-resurfacing in two-stage revision of infected TKA.

This study involved a retrospective comparison of the reinfection rate and clinical outcomes of revision TKA patients managed with patellar resurfacing (22 patients, 23 knees) and patients managed without patellar resurfacing (26 patients) at a minimum two-year follow-up. The mean age in the resurfacing group was 69.4 years old, and the mean age in the non-resurfacing group was 67.3 years old. Three scales were used in the assessment: the Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis Index, and the Anterior Knee Pain Scale.

Three knees had recurrent infections. All infections occurred in patients who had received patellar resurfacing. There were no significant differences between groups in clinical results and on the Anterior Knee Pain Scale. A lack of patellar resurfacing did not increase recurrence of infection and did not result in significant clinical differences compared to patellar resurfacing.

This study indicates that preservation of the original patellar bone is a feasible option for patellar management in revision of septic TKA.

Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.