Resection Technique Does Affect Resection Symmetry and Thickness of the Patella During Total Knee Arthroplasty: A Prospective Randomized Trial

The purpose of this study was to evaluate the accuracy and efficiency of three patellar resection techniques: cutting guide, free hand with haptic feedback, and a novel technique utilizing four quadrant measurements. Ninety patients undergoing TKA were randomized to receive patellar resurfacing by one of the three study techniques. The novel four quadrant technique resulted in least post-resection asymmetry (0.85 mm, P = 0.001). The most accurate methods for obtaining desired thickness were haptic feedback (0.66 mm mean discrepancy [MD]) and novel four quadrant technique (0.66 mm MD) followed by the patellar cutting guide (1.40 mm MD) (P < 0.001). Use of a patellar cutting guide resulted in increased patellar asymmetry and decreased accuracy in obtaining desired patellar thickness in this prospective trial.