In patellectomized patients, the change of extensor mechanism of the knee and the increase of antero-posterior laxity can enhance the risk of femorotibial arthrosis in non-arthrotic knees and worsen the mechanical conditions in preexisting osteoarthritis. Several treatment options had been studies, with mixed clinical results. There is paucity of literature on unicondylar knee arthroplasty in post-patellectomy patients with isolated antero-medial knee arthritis. Research identified six case series (23 patients). The postoperative functional outcome was good to excellent in all reports except one, which described revision surgery of all three patients. After this review we conclude unicondylar knee arthroplasty may be a good treatment option in patellectomized patient with isolated antero-medial gonarthrosis.

The effect of the total re-movement of the patella on the knee function is not negligible. There is a loss of mechanical advantage of the extensor mechanism. Because of reduced moment arm, the quadriceps has to generate a larger force (15% increase in contraction force) to extend the knee.

Total patellectomy is in the modern orthopaedic surgery rarely indicated. The change of extensor mechanism of the knee and the slight increase in antero-posterior laxity can enlarge the risk of osteoarthritis in the patellectomized knee. Several treatment options, e.g. varying types of TKA, had been studies, with mixed clinical results. Instability is the most described postoperative complication in post-patellectomy patients who underwent total knee prosthesis.

In patellectomized patient with isolated antero-medial gonarthrosis and intact cruciate ligaments, a unicondylar knee arthroplasty may be a feasible treatment option. With retention of the ACL, the four-bar linkage system is better preserved. The placement of UKA also allows less soft tissue disruption, shorter hospital stay and faster rehabilitation when compared to TKA. Further well-designed studies with long follow-up durations are needed to confirm our conclusions.

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