Our Summary
This research paper discusses the pros and cons of patella resurfacing, a surgical procedure where the underside of the kneecap is replaced with a plastic surface, during knee replacement surgery. Currently, some surgeons choose to perform this procedure while others do not, leading to inconsistency in its use.
Around one-third of knee replacement patients have their kneecap resurfaced, while two-thirds do not. Surgeons who advocate for patella resurfacing argue that it can help prevent persistent knee pain after surgery, potentially increasing patient satisfaction and avoiding the need for additional surgery down the line. However, additional surgery has its own risks, including a higher chance of infection, increased pain, and higher costs for the healthcare system.
On the other hand, surgeons who generally do not resurface the kneecap believe that this practice doesn’t significantly affect post-surgery pain or patient satisfaction. They also argue that patella resurfacing can lengthen the duration of the surgery and risk causing serious injury to the kneecap and surrounding structures, which can be difficult to treat.
The goal of this review is to determine the most effective and cost-efficient approach to patella resurfacing for adults undergoing elective knee replacement surgery.
FAQs
- What is patella resurfacing and why is it used in some knee replacement surgeries?
- What are the potential benefits and risks of patella resurfacing?
- Does patella resurfacing significantly affect post-surgery pain or patient satisfaction?
Doctor’s Tip
One helpful tip a doctor might give a patient about shoulder replacement is to follow their post-operative care instructions carefully. This may include exercises to strengthen the shoulder, avoiding certain movements or activities, and attending physical therapy sessions. By following these instructions, the patient can help ensure the success of their shoulder replacement surgery and achieve optimal recovery outcomes.
Suitable For
Patients who are typically recommended for shoulder replacement surgery include those with severe shoulder pain and stiffness that limits daily activities, loss of function in the shoulder joint, arthritis, fractures, rotator cuff tears, and failed previous shoulder surgeries. These patients may have tried non-surgical treatments such as physical therapy, medications, and injections without success, and are experiencing persistent pain and limited mobility in the shoulder joint. It is important for patients to discuss their symptoms and medical history with their healthcare provider to determine if shoulder replacement surgery is the right treatment option for them.
Timeline
Before undergoing knee replacement surgery, a patient will typically experience chronic knee pain, limited mobility, stiffness, swelling, and difficulty performing daily activities. They may have tried conservative treatments such as physical therapy, medications, and injections without success.
After the decision is made to proceed with knee replacement surgery, the patient will undergo pre-operative assessments and evaluations to ensure they are a good candidate for the procedure. This may include blood tests, imaging studies, and consultations with the surgical team.
During knee replacement surgery, the damaged parts of the knee joint are removed and replaced with artificial components made of metal and plastic. If patella resurfacing is performed, the underside of the kneecap is also replaced with a plastic surface.
After surgery, the patient will stay in the hospital for a few days for monitoring and rehabilitation. They will work with physical therapists to regain strength and mobility in the knee. Pain management strategies will be used to control discomfort during the recovery period.
In the weeks and months following surgery, the patient will continue with physical therapy and gradually increase their activity level. It may take several months to fully recover and regain normal function in the knee.
Overall, the decision to perform patella resurfacing during knee replacement surgery is a complex one that should be based on individual patient factors, surgeon expertise, and the potential risks and benefits of the procedure. Further research is needed to determine the optimal approach to patella resurfacing for knee replacement patients.
What to Ask Your Doctor
- What are the benefits of patella resurfacing during knee replacement surgery?
- What are the potential risks and complications associated with patella resurfacing?
- How will patella resurfacing affect my recovery time and post-surgery pain levels?
- Are there any specific factors or conditions that would make me a good candidate for patella resurfacing?
- What is the success rate of patella resurfacing compared to not resurfacing the kneecap?
- How long do the results of patella resurfacing typically last?
- Will I need to undergo additional surgeries in the future if I choose not to have my kneecap resurfaced?
- How will the cost of patella resurfacing impact my overall healthcare expenses?
- Are there any alternative treatments or procedures that could achieve similar results without the need for patella resurfacing?
- How many patella resurfacing procedures have you performed, and what is your success rate with this technique?
Reference
Authors: National Guideline Centre (UK). Journal: London: National Institute for Health and Care Excellence (NICE); 2020 Jun. PMID: 32881465