ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
Does patellar resurfacing matter in robotic-assisted total knee arthroplasty with functional alignment principles?
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Functional alignment in robotic total knee arthroplasty provides favourable outcomes and minimal early revisions: A systematic review and meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Pooled it
- Functional alignment: Defined personalized alignment strategy with promising outcomes and room for improvement.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Similar secondary patellar resurfacing but higher tibial revision risk with posterior stabilized versus medial pivot total knee arthroplasty: A registry analysis.Journal of experimental orthopaedics · 2026Article
- Robot-assisted total knee arthroplasty is associated with reduced early anterior knee pain compared with conventional techniques : A propensity score-matched study.Orthopadie (Heidelberg, Germany) · 2026Article
- Retropatellar resurfacing in primary total knee arthroplasty does not improve clinical outcomes but increases revision rates.Archives of orthopaedic and trauma surgery · 2026Observational
- Article
- Robotic-assisted restricted kinematic alignment in total knee arthroplasty: A multicenter retrospective assessment of coronal phenotypes and early postoperative outcomes.Journal of experimental orthopaedics · 2026Article
- Does patellar resurfacing matter in robotic-assisted total knee arthroplasty with functional alignment principles?Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
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7 authors.
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Abstract
purposeWhile new philosophies in total knee arthroplasty (TKA) aim to optimize alignment and ligament balancing, restoring the anterior compartment and understanding the consequences of patella resurfacing remain challenging. This study evaluates the functional consequences of anterior compartment restoration, with a specific focus on patella resurfacing when performing robotic-assisted TKA using functional alignment (FA) principles.
methodsThis retrospective comparative study included 268 patients affected by an end-stage varus osteoarthritis who underwent robotic TKA according to FA principles. Patients were divided into two main groups based on whether patellar resurfacing procedure was performed (study group) or not (control group). Restoration of the anterior compartment and functional outcomes were evaluated using radiographic assessments, along with the Knee Society Score (KSS Knee and KSS Function), Forgotten Joint Score (FJS) and Kujala Score, all recorded at a minimum follow-up of 2 years.
resultsOne hundred thirty-eight cases underwent patellar resurfacing and 130 did not. Patellar tilt and patellar translation were reduced by 74.63% (p < 0.005) and 69.89% (p < 0.005) in the resurfaced group compared to the non-resurfaced group, respectively. The patellar offset values showed no significant differences between the two groups (p = 0.873), although both groups showed a significant reduction in patellar offset in the post-operative compared to the preoperative, 10.31% and 14.29%, respectively, in the resurfaced and non-resurfaced groups (p < 0.05). KSS knee and functional scores were higher in the non-resurfaced group compared to the resurfaced group (p = 0.023 and p = 0.017, respectively). Kujala and FJS scores were similar between the two groups.
conclusionBoth resurfaced and non-resurfaced approaches improve radiographic outcomes regarding the anterior knee compartment after TKA performed with FA and image-based robotic system, without signs of superiority in clinical outcomes in the resurfaced group. The decision of patella resurfacing can be made on an individualized basis. LEVEL OF EVIDENCE: Level II.
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