ASSESSMENT OF FUNCTIONAL RECOVERY FOLLOWING PATELLAR RESURFACING GUIDED BY OSSEOUS ANATOMICAL LANDMARKS IN TOTAL KNEE ARTHROPLASTY PATIENTS
Main Article Content
Keywords
Patellar resurfacing, functional outcome, total knee arthroplasty, anatomical landmarks
Abstract
Objective: The present study aims at the assessment of functional outcomes of patellar resurfacing using bony anatomical landmarks in patients undergoing total knee arthroplasty (TKA).
Study design: A descriptive case series study.
Place and Duration: This study was conducted in, Pakistan Institute of Medical Sciences Islamabad Pakistan Hospital for period of 3 years from January 2022 to January 2025.
Methodology: A descriptive case series was conducted at the department of Orthopaedics. The study involved 200 patients selected via non-probability purposive sampling. Patellar resurfacing was performed using bony landmarks, and patients were followed postoperatively. Follow-ups were biweekly for two months and monthly thereafter. Functional outcomes were classified as excellent, good, or poor. Patients also received guided knee mobilization and dynamic exercise training post-surgery.
Result: The mean age of patients was 58.5 ± 7.8 years. Of the 200 patients, 33% were male and 67% female; 67% were from urban areas. The average disease duration was 4.4 ± 2.1 years; 30.6% had diabetes, 52% had hypertension, and 24% were obese. At six months, 87% showed excellent and 13% good functional outcomes.
Conclusion: Patellar resurfacing guided by bony landmarks is a safe and effective technique in TKA, offering excellent functional recovery and improved quality of life. Better outcomes were linked with younger age and presence of comorbidities such as diabetes and hypertension.
Study design: A descriptive case series study.
Place and Duration: This study was conducted in, Pakistan Institute of Medical Sciences Islamabad Pakistan Hospital for period of 3 years from January 2022 to January 2025.
Methodology: A descriptive case series was conducted at the department of Orthopaedics. The study involved 200 patients selected via non-probability purposive sampling. Patellar resurfacing was performed using bony landmarks, and patients were followed postoperatively. Follow-ups were biweekly for two months and monthly thereafter. Functional outcomes were classified as excellent, good, or poor. Patients also received guided knee mobilization and dynamic exercise training post-surgery.
Result: The mean age of patients was 58.5 ± 7.8 years. Of the 200 patients, 33% were male and 67% female; 67% were from urban areas. The average disease duration was 4.4 ± 2.1 years; 30.6% had diabetes, 52% had hypertension, and 24% were obese. At six months, 87% showed excellent and 13% good functional outcomes.
Conclusion: Patellar resurfacing guided by bony landmarks is a safe and effective technique in TKA, offering excellent functional recovery and improved quality of life. Better outcomes were linked with younger age and presence of comorbidities such as diabetes and hypertension.
References
1. Rand JA, Ilstrup DM. Survivorship analysis of total knee arthroplasty: cumulative rates of survival of 9200 total knee arthroplasties. J Bone Joint Surg Am. 1991;73(3):397–409.
2. Carr AJ, Robertsson O, Graves S, Price AJ, Arden NK, Judge A, et al. Knee replacement. Lancet. 2012;379(9823):1331–40.
3. Nizard RS, Biau DJ, Porcher R, Ravaud P, Hannouche D, Bouabid S, et al. A meta-analysis of patellar replacement in total knee arthroplasty. Clin Orthop Relat Res. 2005;(432):196–203.
4. Pakos EE, Ntzani EE, Trikalinos TA. Patellar resurfacing in total knee arthroplasty: a meta-analysis. J Bone Joint Surg Am. 2005;87(7):1438–45.
5. Pilling RW, Moulder E, Allgar V, Messner J, Sun Z, Mohsen A. Patellar resurfacing in primary total knee arthroplasty: a meta-analysis. J Bone Joint Surg Am. 2012;94(24):2270–8.
6. Kooijman HJ, Driessen AP, van Horn JR. Long-term results of total condylar knee arthroplasty with or without resurfacing of the patella. J Bone Joint Surg Br. 2003;85(6):836–40.
7. Burnett RS, Boone JL, McCarthy KP, Rosenzweig SD, Barrack RL. Patellar resurfacing compared with nonresurfacing in total knee arthroplasty: a concise follow-up of a randomized trial. J Bone Joint Surg Am. 2009;91(11):2562–7.
8. Mihalko WM, Krackow KA. Flexion instability in total knee arthroplasty. Clin Orthop Relat Res. 2006;452:89–94.
9. Matz J, Howard JL, Lanting BA, Teeter MG, Vasarhelyi EM. The accuracy of patellar component positioning using three different referencing techniques in total knee arthroplasty. J Arthroplasty. 2017;32(5):1566–71.
10. Kayani B, Konan S, Tahmassebi J, Rowan FE, Haddad FS. Anterior knee pain after total knee arthroplasty: a review of the literature. Bone Joint J. 2018;100-B(5):556–62.
11. Fu Y, Wang G, Liu X, Zhang Q, Zhang X. Patellar resurfacing versus nonresurfacing in total knee arthroplasty: an updated meta-analysis of randomized controlled trials. J Orthop Surg Res. 2021;16(1):1–11.
12. Choi YJ, Ra HJ, Joo YB. Comparison of patellar resurfacing versus nonresurfacing in bilateral total knee arthroplasty. J Orthop Surg (Hong Kong). 2020;28(1):1–7.
13. Koulalis D, Roidis N, Malizos KN. Surgical technique and pitfalls in patellar resurfacing. Eur J Orthop Surg Traumatol. 2011;21(6):423–8.
14. Waters TS, Bentley G. Patellar resurfacing in total knee arthroplasty: a prospective, randomized study. J Bone Joint Surg Am. 2003;85(2):212–7.
15. National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. 18th Annual Report 2021. [Internet]. NJR; 2021 [cited 2025 Apr 7]. Available from: https://www.njrcentre.org.uk/
16. Rand JA, Ilstrup DM. Survivorship analysis of total knee arthroplasty: cumulative rates of survival of 9200 total knee arthroplasties. J Bone Joint Surg Am. 1991;73(3):397–409.
17. Graves SE, Waddell JP, Naylor JM, et al. Patellar resurfacing in total knee arthroplasty: a randomized controlled trial. J Bone Joint Surg Br. 2002;84(1):52–57.
18. Kooijman HJ, Driessen AP, van Horn JR. Long-term results of total condylar knee arthroplasty with or without resurfacing of the patella. J Bone Joint Surg Br. 2003;85(6):836–40.
19. Pakos EE, Ntzani EE, Trikalinos TA. Patellar resurfacing in total knee arthroplasty: a meta-analysis. J Bone Joint Surg Am. 2005;87(7):1438–45.
20. Mihalko WM, Krackow KA. Flexion instability in total knee arthroplasty. Clin Orthop Relat Res. 2006;452:89–94.
21. Nizard RS, Biau DJ, Porcher R, Ravaud P, Hannouche D, Bouabid S, et al. A meta-analysis of patellar replacement in total knee arthroplasty. Clin Orthop Relat Res. 2005;(432):196–203.
22. Burnett RS, Boone JL, McCarthy KP, Rosenzweig SD, Barrack RL. Patellar resurfacing compared with nonresurfacing in total knee arthroplasty: a concise follow-up of a randomized trial. J Bone Joint Surg Am. 2009;91(11):2562–7.
23. Niaz Hussain Keerio, Nuresh Kumar Valecha, Nasrullah Aamir, Syed Shahid Noor. Knowledge and Awareness of Osteoporosis in Female Population of Hyderabad, Pakistan. JPOA [Internet]. 2020 Sep. 22 [cited 2022 Jan. 12];32(02):97-101.
24. Choi YJ, Ra HJ, Joo YB. Comparison of patellar resurfacing versus nonresurfacing in bilateral total knee arthroplasty. J Orthop Surg (Hong Kong). 2020;28(1):1–7.
25. Kayani B, Konan S, Tahmassebi J, Rowan FE, Haddad FS. Anterior knee pain after total knee arthroplasty: a review of the literature. Bone Joint J. 2018;100-B(5):556–62.
26. Teeter MG, Lanting BA, Howard JL, et al. The accuracy of patellar component positioning using three different referencing techniques in total knee arthroplasty. J Arthroplasty. 2017;32(5):1566–71.
2. Carr AJ, Robertsson O, Graves S, Price AJ, Arden NK, Judge A, et al. Knee replacement. Lancet. 2012;379(9823):1331–40.
3. Nizard RS, Biau DJ, Porcher R, Ravaud P, Hannouche D, Bouabid S, et al. A meta-analysis of patellar replacement in total knee arthroplasty. Clin Orthop Relat Res. 2005;(432):196–203.
4. Pakos EE, Ntzani EE, Trikalinos TA. Patellar resurfacing in total knee arthroplasty: a meta-analysis. J Bone Joint Surg Am. 2005;87(7):1438–45.
5. Pilling RW, Moulder E, Allgar V, Messner J, Sun Z, Mohsen A. Patellar resurfacing in primary total knee arthroplasty: a meta-analysis. J Bone Joint Surg Am. 2012;94(24):2270–8.
6. Kooijman HJ, Driessen AP, van Horn JR. Long-term results of total condylar knee arthroplasty with or without resurfacing of the patella. J Bone Joint Surg Br. 2003;85(6):836–40.
7. Burnett RS, Boone JL, McCarthy KP, Rosenzweig SD, Barrack RL. Patellar resurfacing compared with nonresurfacing in total knee arthroplasty: a concise follow-up of a randomized trial. J Bone Joint Surg Am. 2009;91(11):2562–7.
8. Mihalko WM, Krackow KA. Flexion instability in total knee arthroplasty. Clin Orthop Relat Res. 2006;452:89–94.
9. Matz J, Howard JL, Lanting BA, Teeter MG, Vasarhelyi EM. The accuracy of patellar component positioning using three different referencing techniques in total knee arthroplasty. J Arthroplasty. 2017;32(5):1566–71.
10. Kayani B, Konan S, Tahmassebi J, Rowan FE, Haddad FS. Anterior knee pain after total knee arthroplasty: a review of the literature. Bone Joint J. 2018;100-B(5):556–62.
11. Fu Y, Wang G, Liu X, Zhang Q, Zhang X. Patellar resurfacing versus nonresurfacing in total knee arthroplasty: an updated meta-analysis of randomized controlled trials. J Orthop Surg Res. 2021;16(1):1–11.
12. Choi YJ, Ra HJ, Joo YB. Comparison of patellar resurfacing versus nonresurfacing in bilateral total knee arthroplasty. J Orthop Surg (Hong Kong). 2020;28(1):1–7.
13. Koulalis D, Roidis N, Malizos KN. Surgical technique and pitfalls in patellar resurfacing. Eur J Orthop Surg Traumatol. 2011;21(6):423–8.
14. Waters TS, Bentley G. Patellar resurfacing in total knee arthroplasty: a prospective, randomized study. J Bone Joint Surg Am. 2003;85(2):212–7.
15. National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. 18th Annual Report 2021. [Internet]. NJR; 2021 [cited 2025 Apr 7]. Available from: https://www.njrcentre.org.uk/
16. Rand JA, Ilstrup DM. Survivorship analysis of total knee arthroplasty: cumulative rates of survival of 9200 total knee arthroplasties. J Bone Joint Surg Am. 1991;73(3):397–409.
17. Graves SE, Waddell JP, Naylor JM, et al. Patellar resurfacing in total knee arthroplasty: a randomized controlled trial. J Bone Joint Surg Br. 2002;84(1):52–57.
18. Kooijman HJ, Driessen AP, van Horn JR. Long-term results of total condylar knee arthroplasty with or without resurfacing of the patella. J Bone Joint Surg Br. 2003;85(6):836–40.
19. Pakos EE, Ntzani EE, Trikalinos TA. Patellar resurfacing in total knee arthroplasty: a meta-analysis. J Bone Joint Surg Am. 2005;87(7):1438–45.
20. Mihalko WM, Krackow KA. Flexion instability in total knee arthroplasty. Clin Orthop Relat Res. 2006;452:89–94.
21. Nizard RS, Biau DJ, Porcher R, Ravaud P, Hannouche D, Bouabid S, et al. A meta-analysis of patellar replacement in total knee arthroplasty. Clin Orthop Relat Res. 2005;(432):196–203.
22. Burnett RS, Boone JL, McCarthy KP, Rosenzweig SD, Barrack RL. Patellar resurfacing compared with nonresurfacing in total knee arthroplasty: a concise follow-up of a randomized trial. J Bone Joint Surg Am. 2009;91(11):2562–7.
23. Niaz Hussain Keerio, Nuresh Kumar Valecha, Nasrullah Aamir, Syed Shahid Noor. Knowledge and Awareness of Osteoporosis in Female Population of Hyderabad, Pakistan. JPOA [Internet]. 2020 Sep. 22 [cited 2022 Jan. 12];32(02):97-101.
24. Choi YJ, Ra HJ, Joo YB. Comparison of patellar resurfacing versus nonresurfacing in bilateral total knee arthroplasty. J Orthop Surg (Hong Kong). 2020;28(1):1–7.
25. Kayani B, Konan S, Tahmassebi J, Rowan FE, Haddad FS. Anterior knee pain after total knee arthroplasty: a review of the literature. Bone Joint J. 2018;100-B(5):556–62.
26. Teeter MG, Lanting BA, Howard JL, et al. The accuracy of patellar component positioning using three different referencing techniques in total knee arthroplasty. J Arthroplasty. 2017;32(5):1566–71.
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Published
Apr 21, 2025
Article Details
How to Cite
Nadeem Hassan, Asfandyar Khan, Muhammad Azfar Khanzada, Abdul Samad Qureshi, Niaz Hussain Keerio, & Sajjad Hussain Bhatti. (2025). ASSESSMENT OF FUNCTIONAL RECOVERY FOLLOWING PATELLAR RESURFACING GUIDED BY OSSEOUS ANATOMICAL LANDMARKS IN TOTAL KNEE ARTHROPLASTY PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology, 32(3), 606-611. https://doi.org/10.53555/1y1era60
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Author Biographies
Nadeem Hassan
Senior Registrar Orthopaedics, Pakistan Institute of Medical Sciences Islamabad Pakistan.
Asfandyar Khan
Assistant Professor Orthopaedics, Pakistan Institute of Medical Sciences Islamabad Pakistan.
Muhammad Azfar Khanzada
Orthopaedic Specialist, Dr Sulaiman Al Habib Medical Group Riyadh KSA.
Abdul Samad Qureshi
Assistant Professor Orthopaedics, Indus Medical College Hospital Tando Mohammad Khan Pakistan.
Niaz Hussain Keerio
Assistant Professor Orthopaedics, Muhammad Medical College, Ibn-E-Sina University Mirpurkhas Pakistan.
Sajjad Hussain Bhatti
Assistant Professor Orthopaedics, Pir Abdul Qadir Shah Jillani Institute of Medical Sciences GIMS Gambat Khairpur mir’s Pakistan.
How to Cite
Nadeem Hassan, Asfandyar Khan, Muhammad Azfar Khanzada, Abdul Samad Qureshi, Niaz Hussain Keerio, & Sajjad Hussain Bhatti. (2025). ASSESSMENT OF FUNCTIONAL RECOVERY FOLLOWING PATELLAR RESURFACING GUIDED BY OSSEOUS ANATOMICAL LANDMARKS IN TOTAL KNEE ARTHROPLASTY PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology, 32(3), 606-611. https://doi.org/10.53555/1y1era60