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Related Experiment Videos

Lateral release rates after total knee arthroplasty.

R S Laskin1

  • 1Hospital for Special Surgery, New York, NY 10021, USA.

Clinical Orthopaedics and Related Research
|November 22, 2001
PubMed
Summary

Accurate patellar tracking is crucial for total knee replacement success. The modified no-touch technique significantly reduced unnecessary lateral releases, improving patient outcomes and implant function.

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The Genesis total knee prosthesis: a 10-year followup study.

Clinical orthopaedics and related research·2001

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Proper patellar tracking is essential for optimal function after total knee replacement (TKR).
  • Lateral release is a surgical technique sometimes employed to correct patellar maltracking.
  • The Genesis II prosthesis with a deep-dish tibial insert was utilized in this study.

Purpose of the Study:

  • To evaluate the accuracy of patellar tracking assessment techniques during TKR surgery.
  • To determine the necessity and rate of lateral release procedures.
  • To compare the effectiveness of the nontouch and modified no-touch techniques for evaluating patellar tracking.

Main Methods:

  • 178 patients undergoing TKR with the Genesis II prosthesis were assessed for patellar tracking.
  • The nontouch and axial traction (modified no-touch) techniques were used to evaluate patellar tilt and subluxation.
  • Assessments were performed with the tourniquet inflated and deflated, and after lateral release if indicated.

Main Results:

  • The modified no-touch technique identified fewer cases of lateral patellar tilt and subluxation compared to the nontouch technique before tourniquet deflation.
  • The overall lateral release rate was 6%, primarily in patients with preoperative fixed valgus deformity.
  • Radiographic evaluation showed no significant difference in patellar position between knees that underwent lateral release and those that did not.

Conclusions:

  • The modified no-touch technique is more accurate in assessing patellar tracking, reducing the rate of unnecessary lateral releases.
  • Axial realignment and implant design can effectively centralize the patella, often obviating the need for lateral release.
  • Improved patellar tracking and reduced malalignment were observed postoperatively, with significant improvement by 3 months as quadriceps function returned.

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