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Intra-articular fibrous bands. Patellar complications after total knee replacement
C D Thorpe1, J R Bocell, H S Tullos
1Division of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas 77030.
Summary
Patellofemoral dysfunction after total knee replacement is often caused by fibrous bands. Arthroscopic removal of these bands effectively resolved symptoms in all patients studied.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Patellofemoral dysfunction, characterized by pain and abnormal patellar movement, can occur after total knee replacement (TKR).
- This complication, involving painful popping, catching, grinding, or jumping of the patellar component, affects patient outcomes.
Purpose of the Study:
- To investigate the causes of patellofemoral dysfunction following TKR.
- To evaluate the efficacy of arthroscopic intervention for this complication.
Main Methods:
- A retrospective review of 635 total knee replacements performed between October 1983 and March 1988.
- Arthroscopic evaluation of eleven patients presenting with patellofemoral dysfunction post-TKR.
- Arthroscopic removal of identified intra-articular fibrous bands.
Main Results:
- Eleven out of 635 TKRs (1.7%) developed patellofemoral dysfunction.
- Arthroscopic findings revealed intra-articular fibrous bands as the cause in all cases.
- Specific band formations included transverse bands impeding patellar seating, bands tethering the patella laterally, and bands tethering the patella inferiorly.
Conclusions:
- Intra-articular fibrous bands are a significant cause of patellofemoral dysfunction after total knee replacement.
- Arthroscopic excision of these fibrous bands provides a successful treatment for symptom resolution.