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Related Experiment Videos

Patellar instability after total knee arthroplasty.

J N Grace1, J A Rand

  • 1Mayo Graduate School of Medicine, Rochester, Minnesota.

Clinical Orthopaedics and Related Research
|December 1, 1988
PubMed
Summary
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Proximal realignment is effective for treating lateral patellar instability after total knee arthroplasty (TKA). Combined procedures carry risks, and component revision is necessary for malposition.

Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Knee biomechanics

Background:

  • Lateral patellar instability is a complication following total knee arthroplasty (TKA).
  • Causes include surgical errors, quadriceps imbalance, and trauma.
  • Symptomatic instability significantly impacts patient function and satisfaction.

Purpose of the Study:

  • To evaluate the efficacy of operative realignment techniques for symptomatic lateral patellar instability post-TKA.
  • To compare outcomes of different surgical approaches.
  • To identify risk factors for recurrent instability and complications.

Main Methods:

  • Retrospective review of 25 knees undergoing operative realignment for lateral patellar instability after TKA.
  • Procedures included proximal realignment, combined proximal and distal realignment, and component revision.

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  • Follow-up averaged 50 months, assessing patellar tracking and complications.

    • Main Results:

    • 20 out of 25 knees achieved normal patellar tracking.
    • Five knees experienced recurrent instability.
    • Two patellar tendon ruptures occurred following combined realignment procedures.

    Conclusions:

    • Proximal realignment is recommended for patellar instability post-TKA when component malposition is absent.
    • Component malposition requires revision surgery.
    • Combined proximal and distal realignment should be used cautiously due to risks like patellar tendon rupture.