Patello Femoral Resurfacing

The back of the knee cap (patella) can become arthritic. This tends to occur in people who have kneecaps that maltrack for years and in those who are heavier than their knee caps were designed for.

If the rest of the knee is in good condition, one can take the view resurfacing the worn section and preserving rest of the knee has advantages. A back of knee cap resurfacing is a much smaller operation than a total knee.

Surgery is an open proceedure with a traditional length scar, the back surface of the knee cap where the arthtis is is removed and replaced with a polmer based material fixed with bone cement, the front of the thigh bone upon which the knee cap slides is resurfaced with a cobalt chrome product. The tracking is checked, a lateral release is sometimes required, occasionally a more significant realignment is requied to ensure normal tracking, termed tibial tubercle anteromedialisation. 

Surgery is mostly carried out as day surgery.

I now use the NexGen Gender patello femoral knee resurfacing product which leads in the Australian registry for survivorship (a measure of how long they last).

In general terms they tend not to wear, but other untouched sections of the knee can become involved.

Classic Symptoms

• Pain at the front of the knee
• Pain on stair desent
• Pain on arrising from a low chair (toilet seat / sofa)
• Grinding / graunching behind the knee cap.
• Can give way
• Swelling (not always).

Complications.

Medical complications are unusual as the operation is relatively small. However there are always risks assosciated with an operation and the anaesthetic, for example cardiac arrythmia, mini stroke, chest infection, urine infection are included in the possible risks. With reference to the knee infection, thrombosis, maltracking and the need for further surgery. Numbess of the skin on the outside of the scar is universal and result from the very small nerves that cross the scar and are