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Avoidance of patellar eversion improves range of motion after total knee replacement: a prospective randomized study.

Nele Arnout¹, J Victor, H Cleppe

¹UZ Pellenberg, Weligerveld 1, Pellenberg 3212, Belgium. nelearnout@yahoo.com

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA

|July 9, 2009

Summary

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Knee Joint

Knee Joint

The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris group...

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Patellar dislocation without eversion during total knee arthroplasty (TKA) is safe and enhances knee range of motion (ROM) one year post-surgery. This minimally invasive technique improves functional outcomes for TKA patients.

Area of Science:

Orthopedic Surgery
Minimally Invasive Procedures
Biomechanical Analysis

Background:

Minimally invasive surgery (MIS) is increasingly adopted in total knee arthroplasty (TKA).
The patellar exposure technique can influence surgical outcomes.
Evaluating novel approaches like patellar subluxation is crucial for optimizing TKA procedures.

Purpose of the Study:

To assess the safety and functional results of patellar eversion versus lateral subluxation during TKA.
To compare the impact of two patellar exposure techniques on patient outcomes.

Main Methods:

A prospective, randomized, double-blind trial involving 60 TKA patients.
Group A: Standard medial parapatellar arthrotomy with patellar eversion.
Group B: Medial parapatellar arthrotomy with lateral patellar subluxation.

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Main Results:

Significant improvement in passive range of motion (ROM) in Group B (118° to 131°) compared to Group A (121° to 121°) at 1 year (P=0.003).
Significant improvement in active ROM in Group B (108° to 125°) versus Group A (112° to 115°) at 1 year (P=0.005).
No significant differences observed in other measured parameters (radiographic, VAS, WOMAC, Knee Society Scores, proprioception, strength testing).

Conclusions:

Patellar subluxation without eversion is a safe alternative for knee exposure in TKA.
This technique demonstrates improved range of motion at one year postoperatively.
Patellar dislocation without eversion offers enhanced functional recovery in TKA patients.