Abstract
We performed bilateral total knee replacement (TKR) on nine patients using the Kodama-Yamamoto Mark-III prosthesis and resurfacing the articular surface of the patella unilaterally. The results of the replacement of the articular surface were compared with those of the side with no replacement. All but one of the nine cases underwent simultaneous bilateral procedures. There were seven cases with rheumatoid arthritis and two with osteoarthritis, eight women and one man (average age, 61.7 years) . The average follow-up period was 2 years, 3 months.
There was no difference in clinical evaluation using the knee assessment score designed by the three universities between the side of the resurfaced patella (P plus side) and the un resurfaced side (P minus side) . But there was more incidence of patello-femoral pain and crepitus in the P minus side than in the P plus side. The incidence of radiographical change of the P-F joint was a high 44.4% in the P minus side. No loosening of the patellar prosthesis was seen in the P plus side.
We therefore consider that routine replacement of the P-F joint is advisable with Mark III knee arthroplasty.
