Long-term outcomes of total knee arthroplasty without patellar resurfacing for rheumatoid arthritis

Objectives: Whether to resurface the patella in total knee arthroplasty for patients with rheumatoid arthritis remains controversial. This study evaluated long-term clinical and radiographic outcomes after total knee arthroplasty without patellar resurfacing. Methods: Of 100 knees in 74 patients who underwent total knee arthroplasty without patellar resurfacing, 64 knees in 49 patients were available for follow-up (mean, 13.6 years). Clinical evaluations included the presence of anterior knee pain (AKP) at final follow-up, Knee Society Score, Knee Society Functional Score, and Kujala score. Plain radiographic evaluations assessed patellar thinning and its relationship with clinical outcomes. We also compared outcomes between remission and non-remission groups based on Disease Activity Score in 28 joints using C-reactive protein at final follow-up. Results: The incidence of AKP was 9.3%. At follow-up, Knee Society Scores and Functional Scores had improved significantly (P < .05). Although patellar thinning progressed, it did not appear to affect clinical outcomes or incidence of AKP. Disease activity did not differ significantly between groups or by presence of AKP. Conclusions: Long-term outcomes of total knee arthroplasty without patellar resurfacing in rheumatoid arthritis were favourable, indicating that this approach is acceptable.