Total knee arthroplasty without patellar resurfacing in patients with rheumatoid arthritis

The etiology of anterior knee pain after total knee arthroplasty often is unclear. We prospectively followed 80 patients (139 knees) with rheumatoid arthritis who had total knee arthroplasties without patellar resurfacing from January 1998 to June 2000. We used binary logistic regression to evaluate the predictive value of preoperative anterior knee pain and the state of patellar articular cartilage on postoperative anterior knee pain. We compared the preoperative and postoperative knee and function scores for patients with and without anterior knee pain. The mean followup was 5.8 years (range, 5-7 years). Ninety one percent of the knees (127 of 139 knees) had The Knee Society scores greater than 80. Anterior knee pain developed in 12 of 139 knees (8.5%). Patients who had anterior knee pain had lower knee and function scores compared with patients without anterior knee pain. Two patients had secondary patellar resurfacing. Preoperative anterior knee pain and the state of patellar articular cartilage did not predict postoperative anterior knee pain. Kaplan-Meier survivorship analysis with anterior knee pain as the end point revealed an 88.3% survivorship at 6.5 years postoperatively. Total knee arthroplasty without patellar resurfacing produced satisfactory results in patients with rheumatoid arthritis.