INTERPRETATION There was a clinical ly relevant association between early migration of TKPs and late revision for loosening .
PURPOSE We performed two parallel systematic review s and meta-analyses to determine the association between early migration of tibial components and late aseptic revision .
Total knee replacement with and without patellar resurfacing: a prospective, randomised trial using the profix total knee system.
We have examined the differences in clinical outcome of  total knee replacement ( TKR ) with and without patellar resurfacing in a prospect i ve , r and omised study of 181 osteoarthritic knees in 142 patients using the Profix total knee system which has a femoral component with features considered to be anatomical and a domed patellar implant . The procedures were carried out between February 1998 and November 2002 . A total of 159 TKRs in 142 patients were available for review at a mean of four years ( 3 to 7 ) . The patients and the clinical evaluator were blinded in this prospect i ve study . Evaluation was undertaken annually by an independent observer using the knee pain scale and the Knee Society clinical rating system . Specific evaluation of anterior knee pain , stair-climbing and rising from a seated to a st and ing position was also undertaken . No benefit was shown of TKR with patellar resurfacing over that without resurfacing with respect to any of the measured outcomes . In 22 of 73 knees ( 30.1 % ) with and 18 of 86 knees ( 20.9 % ) without patellar resurfacing there was some degree of anterior knee pain ( p = 0.183 ) . No revisions related to the patellofemoral joint were performed in either group . Only one TKR in each group underwent a re-operation related to the patellofemoral joint . A significant association between knee flexion contracture and anterior knee pain was observed in those knees with patellar resurfacing ( p = 0.006 )
INTERPRETATION There was a clinical ly relevant association between early migration of TKPs and late revision for loosening .
PURPOSE We performed two parallel systematic review s and meta-analyses to determine the association between early migration of tibial components and late aseptic revision .