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length of follow-up.Results: The presence of uniform cement mantle was 100% in group 1as opposed to only 70%(25 out of 36) in group 2. Incidence of metaphyseal RLL was 3.8% (1 out of 26 components) ingroup 1; as opposed to 16.7% (6 out of 36 components) in group 2. The average postoperativeknee society and function score in group 1 was 90 and 80 and in group 2 was 88 and 81respectively at final follow-up.Conclusion: Cemented metaphyseal sleeves along with press fit stems provided reproduciblecement mantle with minimal radiolucencies when compared to similar cases in whom onlystems were used. This minimal incidence of RLLs at 2 years possibly has potential for bettersurvivorship over the long term.Saturday, October 9, 2010, 14:00-14:40Session A21: Knee ArthroplastyPatellar Fracture in TKR With Patellar Resurfacing: The Role of LateralFacet*Prashant Deshmane - Lenox Hill Hospital - New York, USANorberto Baez - - Sabana Grande, USAVijay Rasquinha - Lenox Hill Hospital - New York, USAAmar Ranawat - Lenox Hill Hospital - New York, USAJose Rodriguez - Lenox Hill Hospital - New York, USA*Email: prashantdeshmane@yahoo.comIntroduction: Mechanical integrity of patella can be weakened by the technique of removingthe articulating surface. The senior author developed the technique of maintaining subchondralbone of the lateral patellar facet in early 1980s. Though laboratory studies have demonstrateddeleterious effect of excessive resection of patella on the strains in the remaining bone underload; clinical studies have not shown the importance of strong subchondral bone of lateral facetto have an effect on patellar fracture prevalence. We present the results of our patellar resectiontechnique preserving the subchondral bone of lateral facet.Methods: 393 TKRs were performed between 1989 and 1996 using cruciate substitutingmodular knee with recessed femoral trochlear groove and congruent patello-femoralarticulation. 45 patients with 48 knees died and 37 patients with 41 knees were lost to followup.Three hundred and four knees were followed for an average 10 years (range 5 -16years).Patellar surface was resected with an oscillating saw without the use of cutting guide.The medial facet and most of the articular cartilage of the lateral facet was resected, whilepreserving the subchondral bone of lateral facet. An all-polyethylene implant with single pegwas used in most cases.Results: There have been two fractures in the cohort with prevalence of 0.66%. Eight TKRswere revised for synovitis and osteolysis. Patellar osteolysis was found in 4 of these cases, withloosening of 3 of these patellae, and 1 patellar fracture. Two patellar implants had globalradiolucencies and were considered loose. The average knee score in unrevised knees improvedfile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]