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Related Experiment Videos

Patellar tilt in total knee arthroplasty

R T Laughlin1, B A Werries, S J Verhulst

  • 1Department of Orthopedic Surgery, Wright State University School of Medicine, Dayton, Ohio, USA.

American Journal of Orthopedics (Belle Mead, N.J.)
|April 1, 1996
PubMed
Summary

Patellar tilt after total knee arthroplasty is influenced by preoperative patellar thickness. Medially tilted patellae improve over time, while laterally tilted patellae persist and worsen.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Radiology

Background:

  • Patellar tilt is a critical factor in total knee arthroplasty (TKA) outcomes.
  • Understanding factors influencing patellar tilt is essential for optimizing surgical techniques and implant selection.

Purpose of the Study:

  • To investigate the impact of various surgical parameters on postoperative patellar tilt in TKA.
  • To identify predictors of persistent or worsening patellar tilt.

Main Methods:

  • Retrospective analysis of 89 primary TKAs for osteoarthrosis.
  • Evaluation of patellar tilt using standard 45-degree Merchant-view radiographs preoperatively and postoperatively.
  • Assessment of factors including patellar thickness, alignment, joint line, patellar height, prosthesis type, and follow-up duration.

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Main Results:

  • Preoperatively, 62% of patellae were neutral and 38% were laterally tilted.
  • Postoperatively, a significant positive correlation was found between preoperative patellar thickness and tilt, and a negative correlation with change in thickness.
  • Metal-back patellae showed a higher likelihood of lateral tilt compared to all-polyethylene patellae, with longer follow-up.
  • Medially tilted patellae tended towards neutral over time, while laterally tilted patellae remained tilted or worsened.

Conclusions:

  • Preoperative patellar thickness is a significant predictor of postoperative patellar tilt.
  • Patellar tilt characteristics evolve over time, with lateral tilt being more persistent.
  • Further research into patellar prosthesis design and surgical techniques may mitigate long-term patellar tilt issues.