Moderator Booth: Robert, it says in your abstract that St. Louis is now the largest American city with unresurfaced patellae. You’ve obviously persuaded the local community.
Dr. Barrack: I’ve only been in St. Louis for 15 years, Leo Whiteside has been there 120 years (laughter), so I have to credit him. He’s influenced some high-volume surgeons in the community that never resurfaced a patella, so we have a data set of tens of thousands of patients. I’ve never had to subsequently resurface one of Leo’s knees, or his former fellows, who do unresurfaced patellae.
As far as why Americans are behind, I think it’s the I-95 axis which is the road between Boston, New York and Philadelphia. Seriously, many of our leading surgeons were brainwashed…I mean trained in New York or Boston or Philadelphia. You’re partly to blame Dr. Booth. (laughter)
Moderator Booth: I accept that with honor.
Dr. Haas: There’s a Philly axis there. The issue though is I tried it, I said I’m not going to resurface the patella and I had patients who were not happy. The ones that I re-operated on were not happy campers.
Moderator Booth: So, everybody’s talks now begin with a point that 28% of patients or something approaching that are unhappy with their total knee. It’s because of anterior knee pain. And that’s resurfaced or not, correct? What percentage of that embarrassing number do you think are from the patella and what are from other issues. Things we can’t define?
Dr. Haas: I actually think they are getting it from the patella, whether resurfaced or unresurfaced. There probably are better ways to resurface the patella, but that doesn’t mean that throwing away resurfacing is necessarily the answer. Maybe there are better ways to do it.
Moderator Booth: What percentage of your anterior knee pain would you say are unresurfaced?
Dr. Haas: About 10%.
