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Related Concept Videos

Knee Joint01:23

Knee Joint

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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...
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Bones of the Lower Limb: Femur and Patella01:16

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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Patellar Instability after Total Knee Arthroplasty.

Gabrielle Swartz1, Zuhdi E Abdo2, Sandeep S Bains1

  • 1Department of Orthopaedics, LifeBridge Health, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland.

The Journal of Knee Surgery
|January 3, 2025
PubMed
Summary
This summary is machine-generated.

Patellar instability after total knee arthroplasty (TKA) is a rare complication often caused by improper component positioning. Addressing the root cause through precise surgical technique is crucial for successful treatment and preventing recurrence.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Patellar instability is a rare but serious complication following total knee arthroplasty (TKA).
  • It can lead to chronic dysfunction and necessitate revision surgery.
  • Understanding its causes, diagnosis, and treatment is critical for patient outcomes.

Purpose of the Study:

  • To review the etiologies, diagnostic methods, treatment options, and outcomes for patellar instability post-TKA.
  • To emphasize the importance of accurate component positioning and soft tissue balance during the primary surgery.

Main Methods:

  • Review of common causes, including component malpositioning (femoral, tibial, patellar) and pre-existing knee deformities.
  • Discussion of diagnostic tools such as radiographs and computed tomography (CT) scans.
  • Overview of surgical interventions, including soft tissue realignment, component revision, and lateral retinacular release.

Main Results:

  • Improper component positioning, such as internal rotation or medialization of femoral/tibial components and lateralization of the patellar button, is the most common cause.
  • Valgus knee deformity can exacerbate patellar maltracking.
  • Surgical options vary, with potential complications like patellar osteonecrosis from lateral retinacular release.

Conclusions:

  • Addressing the underlying cause of instability is paramount to prevent recurrence.
  • Meticulous attention to component positioning and soft tissue balance during the index TKA procedure is the most effective preventive strategy.
  • Further research is needed for emerging treatments like medial patellofemoral ligament reconstruction.