Patellar Resurfacing and Crepitation After Total Knee Arthroplasty, Propensity Score Matching
DOI:
https://doi.org/10.56929/jseaortho-2026-0312Keywords:
total knee arthroplasty, patellar resurfacing, patellar crepitation, posterior-stabilized knee, propensity score matchingAbstract
Purpose: Patellar crepitation (PC) is a complication of posterior-stabilized total knee arthroplasty (PS-TKA). However, the role of patellar resurfacing (PR) in the reduction of PC remains controversial. This study aimed to evaluate the effectiveness of PR in reducing PC after PS-TKA.
Methods: This retrospective comparative study included patients aged 55–80 years with Kellgren–Lawrence grades 3–4 knee osteoarthritis who underwent PS-TKA. The patients were divided into resurfaced and non-resurfaced groups. Propensity score matching using sex, body mass index, age, preoperative Knee Society Score, and preoperative Feller score produced 89 matched patients per group. The primary outcome was the presence of patellar crepitus. Secondary outcomes included blood loss, radiographic patellar alignment, functional scores, and complications.
Results: The incidence of PC was significantly lower in the resurfaced group than that in the non-resurfaced group (15.7% vs. 77.5%, p<0.001). The estimated blood loss was higher in the resurfaced group, but the difference was not clinically significant. Functional outcomes were comparable between groups, whereas the Feller knee score and patellar shift favored the resurfaced group.
Conclusions: PR significantly reduces PC and improves patellofemoral function after PS-TKA without increasing the complication rates.
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