Abstract:

BACKGROUND: Whether patellar displacement is performed during total knee replacement or not has been controversial.
OBJECTIVE: To evaluate the efficacy of patellar replacement during total knee arthroplasty systematically, and to provide references for further clinical research and medical practice.
METHODS: In accordance with strict inclusion and exclusion criteria and the pre-developed search strategy, the following databases and journals were searched for relavant articles: Cochrane Central Register of Controlled Trials, MEDLINE-, PubMed-, EMBASE-, CBM, CNKI and VIP. Meta analysis used the Revman 5.0.25 software provided by Cochrane collaboration.
RESULTS AND CONCLUSION: 1788 knees were included in the 14 published trials, including 886 knees in the patellar resurfacing group and 902 in the patellar nonresurfacing group. The result of the meta-analysis indicated that the risk of postoperative anterior knee pain was lower in patellar resurfacing group than in patellar nonresurfacing group between 5 years and 7.5 years. The combined RR was 0.19, 95%CI (0.11, 0.31). But the difference did not exist within 5 years or after 7.5 years. The risk of reoperation had no significant difference between the patellar resurfacing group and patellar nonresurfacing group within 5 years. But 5 years later, the risk of reoperation was lower in the patellar resurfacing group than in the patellar nonresurfacing group. The combined RR was 0.49, 95%CI (0.33, 0.75). Whatever using sub-group analysis or using general analysis, there was no difference in the mean postoperative knee scores. Weighted mean difference for the results of the general analysis was 0.26, 95%CI (-1.39, 1.90). Whatever using sub-group analysis or using general analysis, there was no difference in patient satisfaction. The combined RR for patient satisfaction was 1.01, 95%CI (0.97, 1.05). The efficacy of resurfacing the patella in total knee arthroplasty is better than nonresurfacing the patella in total knee arthroplasty.