High prevalence of radiological patellofemoral joint arthritis after total knee replacement: A retrospective study with >5-Year Follow-up

Abstract

Introduction: Osteoarthritis (OA) of the knee is one of the most common degenerative conditions affecting the elderly people. Arguably the most effective surgical treatment for end-stage OA knee is total knee replacement (TKR). Whether the patella should routinely be resurfaced during TKR remains controversial. Proponents of resurfacing believe that it reduces anterior knee pain and improves knee function after surgery. Opponents of resurfacing argue that it is associated with increased complication rates without any reduction in anterior knee pain. This study aimed to evaluate the long-term incidence of radiological patellofemoral joint arthritis in a cohort of patients from our centre at more than 5 years post-TKR. Methods: All patients who had a TKR operation done at our hospital in 2013 were retrospectively reviewed. Skyline radiographs up to 6 months after surgery were compared with the most recent follow-up skyline radiographs. These radiographs were evaluated for new incidence of patellofemoral joint arthritis after TKR as manifested by new osteophyte formation, joint space narrowing, or subchondral sclerosis or cyst formation. Results: A total of 256 patients were included. Adequate follow-up was available for 231 patients. The incidence of radiological patellofemoral joint arthritis at >5 years after surgery in this cohort was 29.7%. Conclusion: Patellofemoral joint arthritis after TKR is a common radiological finding on long-term follow-up. Further studies should be performed to see if this finding is clinically significant; if it is, routine patella resurfacing in TKR should be reconsidered.