Name of the Procedure:

Arthroplasty, patella; without prosthesis
Common name(s): Patella Reconstructive Surgery, Kneecap Arthroplasty without Implant

Summary

Arthroplasty of the patella is a surgical procedure to reshape or repair the kneecap (patella) without using a prosthetic implant. This surgery is often performed to alleviate pain and improve function and mobility in the knee joint.

Purpose

This procedure primarily addresses issues such as patellar arthritis, severe kneecap pain, and deformities. The goals are to reduce pain, improve knee function, and enhance the patient's overall quality of life without the need for an artificial implant.

Indications

• Severe patellar arthritis causing chronic pain
• Degenerative changes in the patella
• Kneecap deformities
• Failed conservative treatments (e.g., physical therapy, medications)
• Patients who prefer to avoid prosthetic implants

Preparation

• Patients may be instructed to fast for at least 8 hours before surgery.
• Medication adjustments, especially blood thinners, may be necessary.
• Preoperative diagnostic tests include blood work, imaging studies (e.g., X-ray, MRI), and a thorough physical exam.

Procedure Description

1. The patient is placed under general or regional anesthesia.
2. An incision is made over the knee to access the patella.
3. The surgeon reshapes or removes damaged parts of the kneecap.
4. The remaining bone is smoothed to provide a better surface for knee movement.
5. The incision is closed with sutures or staples, and a sterile dressing is applied.

Tools: Surgical scalpel, bone saw, and other orthopedic instruments.
Anesthesia: General anesthesia or regional (spinal/epidural) anesthesia.

Duration

The procedure typically takes 1 to 2 hours.

Setting

This procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technician

Risks and Complications

• Infection at the surgical site
• Blood clots
• Bleeding
• Nerve or blood vessel damage
• Persistent pain or stiffness
• Reaction to anesthesia

Benefits

• Significant pain reduction
• Improved knee function and mobility
• Enhanced quality of life
• No risk associated with prosthetic implants

Recovery

• Patients may need to stay in the hospital for 1-2 days.
• Use of crutches or a walker for a few weeks.
• Physical therapy to aid in rehabilitation.
• Full recovery can take several months, with gradual resumption of activities.

Alternatives

• Conservative management (physical therapy, medications)
• Arthroscopic surgery
• Total knee replacement (with prosthesis)
• Pros: Less invasive, quicker recovery for conservative methods.
• Cons: May not offer long-term relief for severe cases.

Patient Experience

During the procedure, patients will be under anesthesia and should not feel pain. After the procedure, they may experience some pain and swelling, which will be managed with pain medication and ice packs. Physical therapy will play a crucial role in recovery, and it's essential to follow the recommended exercises and activity restrictions to ensure a successful outcome.