Assessment of Patellofemoral Overstuffing on the Results of Total Knee Arthroplasty: An Observational Prospective Study

Background: For severe knee arthritis, total knee arthroplasty (TKA) is a successful surgical procedure. However, complications related to surgical technique, such as patellofemoral overstuffing, can impact postoperative outcomes. Objective: This observational prospective study aimed to assess the influence of patellofemoral overstuffing on TKA outcomes, focusing on clinical parameters, functional scores, and patient satisfaction. Methods: Patients undergoing primary TKA with patellar resurfacing and a patella thickness of 23 mm or less were included. Overstuffing was achieved by resecting less than 8 mm of the patella and placing an 8 mm thick patellar button. Patients were divided into two groups: Group A (with overstuffing) and Group B (without overstuffing). Clinical parameters, functional scores, and patient satisfaction were assessed preoperatively and at three and six months postoperatively. Results: A total of 196 patients (266 knees) were included in the study. Group A comprised 185 patients with overstuffing, while Group B consisted of 81 patients without overstuffing. The differences in mean flexion, Knee Severity Score (KSS) (p-value = 0.4), and Oxford Knee Score (OKS) (p-value = 0.2) between the two groups at three and six months postoperatively were not significant. Furthermore, there were no reports of iatrogenic patellar fractures. Conclusion: Patellofemoral overstuffing, within the parameters studied, did not adversely affect post-TKA outcomes. Further research is warranted to optimize surgical techniques and minimize complications associated with patellar management in TKA.