RT Journal
A1 Breeman, Suzanne
A1 Campbell, Marion
A1 Dakin, Helen
A1 Fiddian, Nick
A1 Fitzpatrick, Ray
A1 Grant, Adrian
A1 Gray, Alastair
A1 Johnston, Linda
A1 MacLennan, Graeme
A1 Morris, Richard
A1 Murray, David
A1 , 
T1 Patellar Resurfacing in Total Knee Replacement: Five-Year Clinical and Economic Results of a Large Randomized Controlled Trial
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2011
FD August 17
VO 93
IS 16
SP 1473
OP 1481
DO 10.2106/JBJS.J.00725
UL http://dx.doi.org/10.2106/JBJS.J.00725
AB Background: 
  There is conflicting evidence regarding the merits of patellar resurfacing during total knee arthroplasty, as many of the previous randomized controlled trials have not been adequately powered.Methods: 
  A pragmatic, multicenter, randomized controlled trial was initiated in 1999 in the United Kingdom. Within a partial factorial design, 1715 patients were randomly allocated to receive or not receive patellar resurfacing during total knee arthroplasty. The primary outcome measure was the Oxford Knee Score; secondary measures included the Short Form-12, the EuroQoL 5D, cost, cost-effectiveness, and the need for subsequent knee surgery.Results: 
  The mean Oxford Knee Score was 35 points at five years postoperatively in both groups. There was no significant difference between the groups with respect to the mean Oxford Knee Score (difference, 0.59 point; 95% confidence interval, –0.58 to 1.76 points) or any other outcome measure at five years postoperatively. The outcome was not affected by whether the patella was domed or anatomic. There was no significant difference between the two groups with respect to the prevalence of knee-related readmission, of minor or intermediate reoperation, or of subsequent patella-related surgery. The total health care cost for the primary arthroplasty, subsequent monitoring, and any revision surgery did not differ significantly between the two groups.Conclusions: 
  In the largest randomized controlled trial of patellar resurfacing reported to date, the functional outcome, reoperation rate, and total health care cost five years after primary total knee arthroplasty were not significantly affected by the addition of patellar resurfacing to the surgical procedure.Level of Evidence: 
  
						Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.