Patella - resurfacing
Submitted by admin on March 14, 2008 - 11:46am.
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Resurfacing (patello-femoral resurfacing) is a form of partial knee replacement where only the back of the patella and the groove of the femur are replaced with artificial components. The procedure is relatively new, and it takes years to effectively evaluate a new surgical technique, so reports of these procedures remain a bit guarded. The design of both the components and the instrumentation is still evolving. Not many surgeons are familiar with the technique, and so total knee replacement is still generally advocated for patients who have painful destruction of the patello-femoral joint. Reports from surgeons who are familiar with resurfacing of the patella and trochlear, however, suggest the results are improving as the procedure becomes more refined. |
Comparison with total knee replacement
To understand the issues, it is necessary to understand that there are three separate areas in the knee cavity where one bone articulates with another -
- Medial and lateral tibio-femoral joints - The two weight-bearing rounded ends of the femur 'articulate' with the flat upper surface of the tibia. In patello-femoral resurfacing these are not replaced, but they are replaced in a total knee replacement (together with the trochlear groove between them, which is a part of the patellofemoral joint).
- Patello-femoral joint - This is the articulation of the patella with the trochlea - not the weight-bearing part of the knee, but nonetheless essential for the quads to work powerfully in straightening the knee. 'Patellofemoral resurfacing' replaces the joint surface of both parts, but in a 'total knee replacement' the patella sometimes is not resurfaced.
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