Influence of femoral implant design modification on anterior knee pain and patellar crepitus in patients who underwent total knee arthroplasty without patella resurfacing

Abstract Background: The incidence of dissatisfaction that due to multiple factors especially anterior knee pain (AKP) and patellar crepitus after total knee arthroplasty (TKA) are still required concern. Improvements of femoral component in traditional prosthesis could reduce the incidence of these complications in TKA with patella resurfacing. This study aimed to explore whether TKA without patella resurfacing benefit from this femoral implant design modification in the aspects of AKP and patellar crepitus.Methods: Sixty-two patients (85 knees) using the modern prosthesis and 62 age-matched and sex-matched patients (90 knees) using the traditional prosthesis were enrolled in this study. The incidences of AKP and patellar crepitus, Knee Society Scores were recorded. Statistical analyses were accomplished to determine if there were differences between the two groups. Results: The incidence of AKP was significantly lower in the study group compared with those in the control group at 3-month and 1-year follow-up (4.7% vs. 13.3%, p = 0.048; 3.5% vs. 13.3%, p = 0.021, respectively). The incidence of patellar crepitus was significantly lower in the study group compared with those in the control group at 3-month and 1-year follow-up (34.4% vs. 15.3%, p = 0.004; 28.9% vs. 10.6% at 1 year, p = 0.002, respectively). There was no significant difference in Knee Society Scores between two groups.Conclusion: The results showed that TKA without patella resurfacing benefited from this femoral implant design modification in the aspects of AKP and patellar crepitus. This study may provide meaningful information for surgeons who use the modern prosthesis and selectively not resurfacing the patella in their patients.