The functional outcomes of total knee arthroplasty in post-patellectomy patients may vary depending upon different factors, including the type of implant used, the preoperative diagnosis, and the time between the patellectomy and arthroplasty.
The patient underwent a left patellectomy for patella instability 47 years prior, from which she recovered reasonably well.
Patellectomy patients represent a specific subset of patients that may develop degenerative arthritis with the associated pain and functional compromise.
Joshi and coworkers (11) evaluated pain relief and knee stability in 19 patellectomy patients following total knee arthroplasty.
There has been some debate over the type of implant that should be used in patellectomy patients because the patella was perceived essential for stability.
A longer elapsed time period between patellectomy and knee arthroplasty is associated with a higher probability of a successful outcome.
Patellectomy patients represent a subset of patients who may require total knee arthroplasty for the treatment of degenerative arthritis.
Total knee arthroplasty after a previous patellectomy.
It is unclear which patients should have patellectomy versus patellofemoral arthroplasty, but an important criterion is the maintenance of better strength after patellofemoral replacement.
Sisto and Sarin (38) and Lonner (39) have advocated patellofemoral arthroplasty rather than total knee arthroplasty or patellectomy for patients younger than 55 years with isolated anterior compartment arthrosis.
They concluded that total knee arthroplasty is a viable treatment option in patients older than 55 with primarily severe patellofemoral disease and that realignment procedures and other osseous procedures such as patellectomy can be avoided.