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Fulkerson procedure for chronic patella component dislocation after total knee arthroplasty
Matthew Price1, Arthur L Malkani, Dale Baker
1Department of Orthopedic Surgery, University of Louisville, Louisville, Kentucky, USA.
The Journal of Arthroplasty
|August 5, 2008
Summary
The Fulkerson procedure effectively treats chronic patella dislocation after total knee arthroplasty. This anteromedialization of the tibial tubercle restored alignment and improved patient scores.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Chronic patella component dislocation is a significant complication following total knee arthroplasty.
- Restoring extensor mechanism alignment is crucial for functional outcomes.
Purpose of the Study:
- To evaluate the efficacy of the Fulkerson procedure for chronic patella dislocation post-total knee arthroplasty.
- To assess functional outcomes and radiographic results of this surgical technique.
Main Methods:
- A case series of five patients with chronic patella dislocation after total knee arthroplasty.
- Surgical treatment involved the Fulkerson procedure (anteromedialization of the tibial tubercle) with lag screw fixation.
- Average tibial tubercle medialization was approximately 1.5 cm.
Main Results:
- Significant improvement in Knee Society scores from 70.5 preoperatively to 85 postoperatively.
- Enhanced knee flexion from 93 degrees preoperatively to 101 degrees postoperatively.
- Achieved adequate patellofemoral alignment and successful union of the tibial tubercle osteotomy site in all patients.
Conclusions:
- The Fulkerson procedure is a viable and effective treatment for chronic patella component dislocation after total knee arthroplasty.
- This surgical approach successfully restores extensor mechanism alignment and improves patient function.