Total patellectomy in knees without prior arthroplasty: a systematic review

Abstract

Purpose: Total patellectomy is a radical procedure and is only used as a last resort. The functional results reported in the literature are contradictory. The purpose of this review of the literature is to evaluate the functional outcome that can be expected after total patellectomy.

Methods: The systematic review was conducted in accordance with the PRISMA statement criteria using the PubMed/MEDLINE database, the EMBASE database, the Cochrane library databases, and the OVID database. Patellectomies were performed either alone or in conjunction with reinforcement of the extensor mechanism; they were longitudinal or transverse. Analysis was first descriptive and then comparative based on medians.

Results: Research identified 394 articles, of which 31 have been included in this review, describing a total of 1,416 knees with a mean follow-up of 7 years. The mean percentage of outcomes judged good or excellent per article was 68.8% (min-max: 29-100%). The complication rate identified was 20.3% (7.6% without calcifications). The functional outcome was considered better in the group undergoing reinforcement of the extensor mechanism [median of percentages per article at 93, IQR = (74-95) vs. 67 (55-79) in the group patellectomy alone].

Conclusion: Total patellectomy gives good or excellent results in 85% of cases if reinforcement is performed with a longitudinal excision.

Level of evidence: IV.