The evolution of patella to assess the possibility of patellar resurfacing in patients undergoing total knee arthroplasty

Introduction: Total knee arthroplasty (TKA) is a highly successful procedure that canreduce pain and improve range of motion and function by correcting angular deformityand restoring the integrity of the articular surface. Currently, joint replacement for varioustypes of knee arthritis is very common, and TKA can claim to be one of the greatestsurgical advances.Objective: To determining about the suitability of implants available for Bangladeshipopulation by assessing the intra op measurement of patella in all its dimensions vizanteroposterior, superioinferior and mediolateral diameter in Bangladeshi patients.Methods: A cross-sectional study was carried out at Department of Orthopaedic Surgery,BSMMU, Dhaka, Bangladesh from January to June 2023. Total 60 patients of grade 4 OAknee were selected for this study and pre op x-rays were obtained, AP View, Lat View,Skyline view and Merchant view. Preop Morphometry of patella was recorded on x-rayfindings. All patients were operated by standard midline incision with medial parapatellararthrotomy. Intra op measurement of patella was done via Vernier caliper andmeasurements were recorded.Results:Total 60 patients of grade 4 OA knee were selected for this study. The smallestavailable patellar implant in Bangladesh is about 8 mm in size which is not suitable forBangladeshi patient. most of the patients were having patellar morphometery lower thanthe expected size for patellar resurfacement. Hence, patellar resurfacement was not anoption for many of the patients because of unavailability of patellar implants ofappropriate size.Conclusion: Hence in this study we conclude that there is a need of better designedimplants for Bangladeshi patients as the presently available implants are mainly designedfor western population making it unfeasible to resurface patella for Bangladeshi surgeons.