Abstract:

BACKGROUND: There is controversy on whether the patellar resurfacing should be performed during total knee arthroplasty.
OBJECTIVE: To compare the outcomes of total knee arthroplasty with or without patellar resurfacing, and to analyze the problems and the strategies that need to be improved of patellar resurfacing.
METHODS: The PubMed database, Medline database, Elsevier database, Embase database, OVID database, ProQuest database, Springer database, BlackWell database, JohnWiley database, CBM database, CNKI database and VIP database were used to search the randomized controlled trials on total knee arthroplasty with or without patellar resurfacing that published before 2011-11-15. For the articles of the same sample, we selected those with the longest follow-up. The reoperation rates, incidence of anterior knee pain and functional scores were analyzed by the Revman 5.0 software provided by the International Cochrane Collaboration Group.
RESULTS AND CONCLUSION: A total of 18 randomized controlled trials of 7 075 patients were selected (3 463 in the resurfacing group and 3 612 in the non-resurfacing group). Meta-analysis showed that there was no significant difference of the incidence of anterior knee pain between resurfacing group and non-resurfacing group (RR=0.150, 95%CI: 0.129-0.185, P > 0.05). Compared with non-resurfacing group, the reoperation rates more than 5 years in the resurfacing group was decreased (RR=0.135, 95%CI:0.118-0.166, P < 0.05). There was no significant difference of the functional scores between two groups (WMD=-0.144, 95%CI: -1.122-2.109, P > 0.05). It indicates that there is no significant difference in the outcome of total knee arthroplasty with or without patellar resurfacing, so more usage of national registry joint replacement data should be encouraged to provide the basis for the identification of whether the patellar resurfacing should be performed during total knee arthroplasty.