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Olecranization of the patella

J L Rungee1, M J Fay, T M Deberardino

  • 1Sports Medicine Section, Tripler Army Medical Center, Honolulu, Hawaii.

Orthopedics
|January 1, 1995
PubMed
Summary

Olecranization of the patella, a technique for posterior cruciate ligament (PCL) repair, incorrectly assumes constant patellar positioning. This method actually applies harmful posterior forces to the PCL during knee flexion.

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Area of Science:

  • Orthopedic Surgery
  • Biomechanics
  • Sports Medicine

Background:

  • Olecranization of the patella is a surgical technique used after posterior cruciate ligament (PCL) repairs.
  • It aims to maintain normal knee joint alignment by using a pin through the patella and tibia.
  • The technique theoretically allows knee motion while protecting the PCL from posterior drawer forces.

Purpose of the Study:

  • To investigate the efficacy of olecranization of the patella in protecting the PCL.
  • To analyze the spatial relationship between the patella and tibia during knee flexion.
  • To determine the effect of olecranization on PCL forces.

Main Methods:

  • Lateral radiographs of 20 normal knees were taken at 0, 30, 60, and 90 degrees of flexion.
  • Two distinct arcs of patellar motion (patellar tendon arc and patellar arc) were defined.
  • PCL forces were measured in six cadaver knees using tension measurement, radiography, and fluoroscopy.

Main Results:

  • The study identified two arcs of patellar motion during knee flexion: a 30-degree patellar tendon arc and a 22-degree patellar arc.
  • Olecranization of the patella does not protect the PCL as intended.
  • The technique was found to induce a detrimental posterior drawer force on the PCL during knee flexion.

Conclusions:

  • The concept that olecranization of the patella maintains a constant spatial relationship with the tibia during flexion is erroneous.
  • This technique fails to protect the PCL and can actively harm it.
  • Alternative methods should be considered for PCL repair and reconstruction that do not involve olecranization.

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