• Angelo V Vasiliadis, FermínTheodorakys MarínTM0000-0002-1698-9517Centro Médico Profesional Las Mercedes, Caracas, 1080, Venezuela., Vasileios Giovanoulis, Ayyoub A Al-Dolaymi, Cécile Batailler, and Sébastien Lustig.
• Department of Orthopaedic Surgery, Sports Trauma Unit, St. Luke's Hospital, Panorama, Thessaloniki, 55236, Greece. vasiliadis.av@gmail.com.
• Arch Orthop Trauma Surg. 2024 Aug 1; 144 (8): 364936553649-3655.

PurposeThe aim of the present study was to report the approach of Greek surgeons regarding patellar management and provide the outcomes and the rate of the need for secondary patella resurfacing.MethodsFollowing the PRISMA guidelines, PubMed, Scopus, and The Cochrane Central Register of Controlled Trials (CENTRAL) databases were accessed in January 2024. Clinical studies evaluating the outcomes of patients undergoing primary TKA were considered eligible for this systematic review if the following predefined criteria were fulfilled: (1) published in English, (2) were conducted in Greece, and had a minimum of 2-year follow-up. The methodological quality and publication bias were assessed using the Modified Coleman Methodology Score (mCMS) and ROBIS tool, respectively. Data was presented in tables using absolute values from individual studies. Pooled data were presented as means, ranges, and percentages.ResultsSix clinical studies with a total of 1084 TKAs were included. Four studies were retrospectives, and two studies were prospective. Patella was only resurfaced in 0.6% of total TKAs. TKA without patellar resurfaced, which resulted in an improvement in functional outcome. Among studies, the overall need for revision incidence was 7.6% (68 out of 892 TKAs). Additionally, Aseptic loosening (2.4%) was the most common reason for revision due to patellofemoral joint complications, followed by secondary patellar resurfacing (2.1%) and deep infection (1.3%). The mean mCMS demonstrated a fair methodological quality level, and the ROBIS toll a low risk of bias in all four domains.ConclusionThe available evidence supports that Greek surgeons mainly do not resurface the patella. However, patellar non-resurfacing yields good functional outcomes and presents relatively low revision rates for secondary patellar resurfacing.Level Of EvidenceIV.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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