Befit Patelloplasty in TKA: A Targeted Approach to Improve Pain and Function

Background Patelloplasty offers a bone-preserving alternative to patellar resurfacing and retention during total knee arthroplasty (TKA) by reshaping the native patella to improve tracking and potentially reduce anterior knee pain (AKP). This study assesses the association between patelloplasty and early postoperative outcomes, including AKP incidence, functional recovery, and complication rates. Methods In this retrospective, single-center study, 408 patients (727 knees) underwent TKA with patelloplasty between December 2017 and December 2023. Outcomes assessed at 3 and 6 months included AKP incidence, range of motion (ROM), unaided walking, stair climbing, and the need for manipulation under anesthesia (MUA). Descriptive and inferential statistics were applied, with effect sizes estimated using Cramér’s V. Results AKP incidence declined from 8.8% at 3 months to 2.7% at 6 months. By 6 months, 86.0% of knees achieved full ROM(≥110° flexion), 77.9% of patients walked unaided, and 72.1% climbed stairs. Among patients impaired at 3 months, 71.3% regained unaided walking and 95.4% regained stair-climbing ability. MUA was required in only 3.2% of cases. Conclusion In this observational cohort, patelloplasty was associated with favorable early clinical outcomes, including reductions in AKP, improvements in mobility, and low complication rates. While these findings are encouraging, prospective controlled studies with longer follow-up and standardized outcome measures are warranted to substantiate the potential role of patelloplasty in contemporary TKA.