Patellar Resurfacing

A procedure to replace damaged patellar cartilage and improve knee function

The patella plays a crucial role in knee function, facilitating smooth movement of the joint during activities such as walking, climbing stairs, and bending. Damage to the cartilage on the patella can lead to pain, stiffness, and impaired mobility.

Common Reasons for Patellar Resurfacing Surgery

  • Isolated cartilage damage on the back of the kneecap due to arthritis or injury.
  • Chronic pain and reduced mobility that do not respond to non-surgical treatments.
  • Difficulty performing daily activities such as walking, bending, or climbing stairs.

Goals of the Procedure:

  • Relieve pain caused by patellar cartilage damage.
  • Restore smooth movement of the kneecap within the knee joint.

Improve mobility and enhance overall knee function.

Preparation for Surgery

Dr Ben McGrath will conduct a detailed evaluation, including imaging studies such as X-rays, MRIs, or CT scans, to assess the extent of patellar damage and determine the most appropriate surgical approach.

Key Steps in Preparation:

  • Consultation: Dr McGrath will explain the procedure, discuss potential benefits and risks, and answer any questions.
  • Pre-Surgical Instructions: Patients may need to fast before surgery and adjust medications, such as pausing blood thinners.
  • Prehabilitation: Strengthening the muscles around the knee may optimise recovery.

Lifestyle Adjustments: Maintaining a healthy weight and ceasing smoking may improve surgical outcomes and enhance healing.

What Happens During the Surgery?

Patellar resurfacing is typically performed under regional or general anaesthesia and may be combined with other knee procedures if necessary.

Surgical Steps:

  1. Incision: A small incision is made over the knee to access the joint.
  2. Cartilage Preparation: Damaged cartilage on the back of the patella is removed, leaving a smooth surface for the implant.
  3. Implant Placement: A prosthetic component, often made of metal and plastic, is securely attached to the back of the patella to replace the damaged cartilage.
  4. Joint Alignment Check: The knee is tested for smooth movement and proper alignment.
  5. Closure: The incision is closed with sutures or adhesive strips, and the knee is bandaged for protection.

The procedure typically takes 1 to 2 hours, depending on the complexity.

Understanding the Risks

As with any surgical procedure, patellar resurfacing carries potential risks:

  • Infection: At the surgical site or within the joint.
  • Blood Clots: Rare but possible in the legs or lungs.
  • Implant Issues: Loosening or wear over time.
  • Residual Pain or Stiffness: Some patients may experience ongoing discomfort.
  • Nerve or Vessel Injury: Extremely rare but possible during surgery.

Dr McGrath employs advanced surgical techniques and follows strict protocols to minimise these risks.

What to Expect After Surgery

Immediate Post-Operative Care:

  • Pain Management: Swelling and discomfort can be managed with prescribed medications and regular icing.
  • Assistive Devices: Crutches or a walker may be used during the initial recovery period.
  • Discharge Instructions: Clear guidance will be provided on wound care, physical activity, and follow-up appointments.

Rehabilitation and Recovery

A tailored rehabilitation program is essential for optimal recovery and long-term success.

Phase 1: Early Recovery (Weeks 0–6)

  • Goals: Protect the joint, reduce swelling, and regain basic mobility.
  • Activities: Non-weight-bearing or partial weight-bearing with assistive devices, range-of-motion exercises, and cryotherapy.

Phase 2: Strength and Stability (Weeks 6–12)

  • Goals: Restore strength and flexibility.
  • Activities: Physiotherapy focusing on controlled exercises, light cycling, and progressive weight-bearing.

Phase 3: Advanced Recovery (Months 3–6)

  • Goals: Improve functional strength and prepare for daily activities or sports.
  • Activities: Strength training, balance exercises, and functional drills tailored to individual needs.

Long-Term Outcomes

Patellar resurfacing may help restore smooth knee function, relieve pain, and improve mobility. Long-term success depends on:

  • Adherence to the rehabilitation program.
  • Regular follow-up visits to monitor joint health and implant performance.
  • Maintaining a healthy lifestyle to minimise stress on the joint.

With appropriate care, the prosthetic components may provide lasting improvements in knee function and quality of life.