Does the severity of patellofemoral arthritis affect the functional outcomes after total knee arthroplasty without patellar resurfacing: a prospective study

Background: The role of patellofemoral (PF) arthritis severity in influencing functional outcomes after total knee arthroplasty (TKA) without patellar resurfacing remains controversial. This study aimed to evaluate the effect of PF arthritis severity on postoperative functional outcomes following primary TKA without patellar resurfacing. Methods: A prospective observational study was conducted on 37 patients undergoing primary TKA without patellar resurfacing. Patients were stratified based on the severity of PF arthritis using the Iwano classification. Functional outcomes were assessed using the knee society score (KSS) and WOMAC score at 3, 6, and 12 months postoperatively. Statistical analysis was performed to compare outcomes across severity groups. Results: There was a statistically significant improvement in mean KSS from 55.9 preoperatively to 87.6 at final follow-up (p<0.001). The mean WOMAC score improved from 88 preoperatively to 41 postoperatively (p<0.001). Improvement in range of motion was also significant. No statistically significant difference in functional outcomes was observed between different grades of PF arthritis. Conclusion: Primary TKA without patellar resurfacing results in significant functional improvement irrespective of the severity of PF arthritis. The severity of PF arthritis does not significantly influence postoperative outcomes.