The outcome of secondary resurfacing of the patella following total knee arthroplasty: Results from the Trent and Wales Arthroplasty Register

Background

We sought to determine whether patients undergoing secondary patella resurfacing (SPR) benefited from the procedure by assessing postoperative satisfaction via a postal questionnaire.

Methods

All such patients included in the Trent and Wales Arthroplasty Register were invited to participate using patient-reported outcome measures (PROMs). We identified 223 patients who had undergone SPR over a 20-year period. Forty-two had died according to death register checks. Eighty-eight of 181 (48.6%) questionnaires were completed. The mean age at resurfacing was 67 (min. 42, max. 81); 52% were female. The median time to follow-up was 55 months (interquartile range (IQR) 41–111). Median time to SPR was 28 months (IQR 20–42).

Results

Thirty-nine patients (44%) felt that SPR resolved the problem of pain in the front of their knee. All PROMs were significantly better for those who felt that the resurfacing had worked (Oxford Knee Score 29 vs. 16, P < 0.05, modified Kujala 51 vs. 32, P < 0.05, EQ5D-3L 0.616 vs. 0.384, P < 0.05). Based on PROMs, SPR produces a satisfactory outcome in two of every five patients.

Conclusions

Surgeons must be clear on the cause of anterior knee pain post-total knee replacement, and patients must be made aware of what outcomes can be reasonably expected from this procedure.