Total knee arthroplasty without patellar resurfacing in isolated patellofemoral osteoarthritis

Abstract: Thirty-one patients (33 knees) with symptomatic patellofemoral osteoarthritis and minimal tibiofemoral changes underwent LCS total knee arthroplasty without patellar resurfacing. Average age was 73 years (range, 58-89 years) with a female-to-male ratio of 5:1. Average follow-up was 20 months (range, 12-40 months). All except 4 patients had grade 3 or 4 patellofemoral osteoarthritis. Preoperatively, all patients had significant knee pain. Sleep disturbance was reported in 21 patients. All but 10 patients required walking aids. Average range of motion was 108° (range, 80-125°). At latest review, 21 knees were pain-free, the remaining 12 knees being described as having only occasional knee pain. Two patients continued to have night pain. Average range of motion was 104° (range, 70-135°). Lateral patellar tilt improved in all but 5 knees by an average of 7° (range, 1-26°). Patellar congruency improved in all but 3 knees by an average of 18% (range, 3-63%). None of the patients to date have required revision surgery. Total knee arthroplasty without patellar resurfacing is an effective option in older patients with isolated patellofemoral osteoarthritis.