Total Knee Arthroplasty After Patellectomy

Mont, Michael A.; John, Mario; McGrath, Mike S.; Bonutti, Peter A.; Zywiel, Michael G.

doi:10.1053/j.sart.2009.09.010

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Volume 20, Issue 3 , Pages 178-182, September 2009

Total Knee Arthroplasty After Patellectomy

Michael A. Mont, MD
- Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD
- Address reprint requests to Michael A. Mont, MD, the Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2401 W Belvedere Ave, Baltimore, MD 21215
Mario John, MD
- Department of Orthopaedics, Howard University Hospital, Washington, DC
Mike S. McGrath, MD
- Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD
Peter A. Bonutti, MD
- Bonutti Clinic, Effingham, IL
Michael G. Zywiel, MD
- Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD

The techniques for total knee arthroplasty in patients who have undergone previous patellectomy are limited in their description. This report briefly reviews the historical and current indications for patellectomy, describes the biomechanics of the patella as well as patella-deficient knees, and presents the techniques and previously reported results for patellar reconstruction at the time of total knee arthroplasty including autograft bone reconstruction, allograft implantation, and the use of a prosthetic patella. While the reported results are limited to a small number of patients, it appears that patellar reconstruction at the time of total knee arthroplasty can provide successful results in appropriately selected patients.

Keywords: total knee replacement, patella, autograft, allograft, functional outcome