The Effect of Partial Lateral Facetectomy of the Patella on the Radiographic and Clinical Outcome of Unresurfaced Patellar-retaining Total Knee Arthroplasty

Management of patellar maltracking during primary TKA is of considerable importance. Lateral release, which is generally performed for this purpose, is associated with several complications. 

In this study, we aimed to evaluate the role of partial lateral facetectomy in tracking the patella in Total Knee Arthroplasty (TKA). 

In a retrospective study, the efficiency of partial lateral facetectomy of the patella in achieving proper tracking of the patella was evaluated in 116 patients who underwent unresurfaced patellar-retaining TKA. The radiographic outcome measures included the patellar tilt and patellar shift. The functional outcome was assessed with Kujala anterior knee pain scale. 

The Mean±SD age of the patients was 66.3±7.6 years. The mean follow-up of patients was ‎‎20.6±8.9 months. The Mean±SD patellar tilt was ‎‎10.5±7.2‎‎‏°‎‏ before the surgery and ‏‎4.4±5‎‎‏° after ‏the operation ‏‎ (‎P‎<‎‏0.001‏‎). ‎The Mean±SD preoperative patellar shift was ‏‎3.3±4.3‎‏ mm which improved to ‏‎-‎‎0.2±2.8°‎‏ after the surgery ‏‎(‎P‎<‎‏0.001‏‎). ‎The Mean±SD Kujala score of the patients was ‏‎74.6±7.1‎, ‎‏ ‏ranging ‎from 54 ‏to ‎‏89. ‎No complication was recorded during the follow‎-‎up period.

Partial lateral facetectomy of the patella provides an acceptable radiographic and ‎functional outcome in patients undergoing primary TKA. Therefore, it could be regarded as a ‎valuable alternative to lateral release in unresurfaced patellar-retaining TKA.‎