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Patellar tracking after total knee arthroplasty performed without lateral release.
Chae-Gwan Kong1, Hyun-Min Cho, Kyung-Hwan Suhl
1Department of Orthopedic Surgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea, Uijongbu-Si, Kyonggi-Do, Republic of Korea.
The Knee
|October 19, 2011
Summary
Total knee arthroplasty (TKA) without lateral release can increase patellar tilt and displacement. Preoperative patellar issues predict postoperative maltracking, highlighting the need for careful patient selection in TKA surgery.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Patellar maltracking is a concern following total knee arthroplasty (TKA).
- Limited data exists on patellar behavior after TKA performed without lateral release, particularly using the subvastus approach.
- Understanding risk factors for maltracking is crucial for improving TKA outcomes.
Purpose of the Study:
- To investigate the incidence and predictors of patellar maltracking after TKA performed without lateral release.
- To evaluate the effect of the subvastus approach on patellar kinematics post-TKA.
- To identify preoperative radiographic factors associated with postoperative patellar maltracking.
Main Methods:
- Retrospective review of 191 TKAs performed via subvastus approach without lateral release (2007-2008).
- Radiographic analysis of preoperative and 2-year postoperative images.
- Multivariate logistic regression to identify risk factors for patellar maltracking.
Main Results:
- Total knee arthroplasty (TKA) significantly increased patellar tilt and displacement postoperatively (P<0.05).
- Preoperative patellar tilt and displacement were significant predictors of postoperative patellar tilt and displacement (P<0.05).
- The subvastus approach without lateral release did not prevent postoperative patellar maltracking.
Conclusions:
- Total knee arthroplasty (TKA) performed without lateral release, even with the subvastus approach, can lead to increased patellar tilt and displacement.
- Preexisting patellar tilt and displacement are key risk factors for developing maltracking after TKA.
- Further research should focus on strategies to mitigate patellar maltracking in TKA patients without lateral release.