Abstract

SILVA, Manuel et al. Protese da rótula: Estudo comparativo em artroplastias do joelho. Rev. Port. Ortop. Traum. [online]. 2013, vol.21, n.2, pp.201-207. ISSN 1646-2122.

Controversy regarding patellar substitution in total knee arthroplasty (TKA) remains a question without consensus in the orthopedic community. The purpose of this work was to evaluate the clinical and imagiological benefits of patellar substitution in TKA, as well as the presence of complications. The authors present a retrospective work of patients who underwent TKA between 2003 and 2008, divided in two groups: Group A with patellar substitution and Group B without. For each group was calculated the Knee Society Score (KSS) preop and postop, anterior knee pain e pain climbing stairs using VAS scale, and the presence of reintervention. All the patients were studied with x-ray and CT 46 patients, 11 men and 33 women, with a mean age of 66 years (53-79) and a mean follow up of 39 months. In the postop patients in group A presented KSS S 85,73 and group B 74,65(p=0,008). KSS F was 82,39 and 65,87 (p=0,006) respectively in groups A and B. Regarding anterior knee pain patients in group A presented VAS 2,30 and patients in group B 4,04 (p=0,006), in pain climbing stairs the results were 3,2 and 5,0 respectively in groups A and B (p=0,051). Radiologically there were no differences between the groups. Two patients were reoperated for patellar realignment and 5 for patellar substitution in group B, there were no reoperations in group A. Despite these are limited numbers in terms of sample size and follow up time, these data are supportive of patellar substitution in patients who undergo TKA, specially in those with persistent anterior knee pain. Taking these results in consideration, we recommend the performance of patellar substitution in patients who undergo TKA

Keywords : Knee arthroplasty; patellar substitution; anterior knee pain.

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