N°270 - January 2018
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How and why we resurface the patella
Our indications for resurfacing
Whilst orthopedic surgeons will continue to debate the merit of patella resurfacing in total knee replacement (TKR), there is no doubt that information worldwide from the registries shows the revision rate is lower in patients whose primary TKR includes patella resurfacing. The clinical results are the same (1,2). The epidemiology of failure mechanisms is changing as new implants, technology, and surgical techniques evolve.
Our objectives with resurfacing
The goals when resurfacing the patella are to create a combined construct of the remaining native patella and polyethylene that is approximately equal to the thickness of the original patella, is well covered by polyethylene and tracks stably within the prosthetic trochlea groove (3).
This article provides the author’s technique for patella resurfacing that reliably and consistently creates a construct that is approximately equal in thickness to the native patella prior to the onset of osteoarthritis with the prepared bone surface being approximately parallel to the anterior cortex of the patella.
Our choice among the different techniques
The two common methods for patella preparation are to use an oscillating saw with or without some form of cutting jig or to use a mill. The disadvantages...
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