Aseptic loosening of the patellar component at the cement–implant interface

Rath, N.K.; Dudhniwala, A.G.; White, Simon; Forster, M.C.

doi:10.1016/j.knee.2011.08.006

Cited by 11 publications

(7 citation statements)

References 18 publications

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“…Daily range of movement of the knee results in shearing coronal forces as well as compressive sagittal forces across the patellofemoral joint (PFJ). The magnitude of the joint reaction force (JRF) increases as the knee flexes to maintain equilibrium against rising quadriceps force and patella tension [7,8]. The JRF during flexion increases fourfold compared to during extension [9].…”

Section: Discussionmentioning

confidence: 99%

“…There is a lateral shear force acting on the patella button between 0° to 50°; this shear force changes its direction to the medial side as the knee flexes from 55° to 90° [10]. These changes in the direction of the articular shear force result in a cyclic rocking effect on the cement peg interface in a medial-lateral fashion [8]. These forces and the changes that occur during extension and flexion are transmitted to the cement implant interface both in the coronal and sagittal planes, causing patella component loosening [8].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Rare Presentation of Patella Button Aseptic Loosening After a Total Knee Replacement Without Evidence of Radiographic Loosening

Teh¹,

Kassim²,

Chopra³

et al. 2023

Cureus

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Patella resurfacing in total knee replacement (TKR) has been shown to reduce the rate of anterior knee pain, but there are complications from patella resurfacing. A 54-year-old male underwent a left primary TKR with patella resurfacing 15 years ago. He developed spontaneous progressive anterior knee pain for six months. At revision surgery, his patella button was found to be loose. Loosening of a three-peg patella button is rare. A high index of suspicion of patella button loosening should be suspected in patients who present with anterior knee pain after patella resurfacing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Rare Presentation of Patella Button Aseptic Loosening After a Total Knee Replacement Without Evidence of Radiographic Loosening

Teh¹,

Kassim²,

Chopra³

et al. 2023

Cureus

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“…Even after the component had loosened, the patient reported none of the complaints that are common in this situation, such as pain or restriction of knee movements. 6 The event was only noticed when transcutaneous extrusion of the component occurred. The patient only presented because it was time for his annual routine post-arthroplasty consultation.…”

Section: Discussionmentioning

confidence: 99%

“…5 The loosened patellar component most commonly migrates to the intra-articular region of the knee. 6 However, there have been a few reports of migration of the component to the extraarticular region, 7,8 particularly when release of the lateral retinaculum and osteonecrosis of the patella are involved. 9 The authors report a case of patellar component loosening and extra-articular and transcutaneous migration of the component 9 years after TKA.…”

Section: Figurementioning

confidence: 99%

Loosening of the Patellar Component and Extra-articular and Transcutaneous Migration After TKA

Helito¹,

Gobbi²,

Tírico³

et al. 2014

Orthopedics

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Replacement of the patella during total knee arthroplasty (TKA) remains controversial. Despite some attempts to establish guidelines for this procedure, there is still no consensus in the literature. When the patella is replaced, the patient is subjected to certain complications, including loosening of the component. The loosened patellar component most commonly migrates to the intra-articular region of the knee. However, there have been a few reports of migration of the component to the extra-articular region, particularly when release of the lateral retinaculum and osteonecrosis of the patella are involved. The authors report a case of patellar component loosening and extra-articular and transcutaneous migration of the component 9 years after TKA. This report is unique because, during the primary procedure, no lateral release was performed and no patellar necrosis was evident on radiographs. The component was removed in the operating room and the wound cleaned and closed. Because of the probable slow migration of the component, there was no communication between the external environment and the joint at the time of surgery. There were no further complications after the wound healed. This case emphasizes the need for periodic radiographic follow-up after TKA.

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“…With increased concern about aseptic loosening, tension, and osteolysis at the bone–cement interface for cemented components, these studies suggest that uncemented patellar designs could provide a reasonable alternative. 115 , 117 , 118 However, Chan et al reported a minimum 20% rate of component fracture at an average of 5.4 years following cementless TKA, and thus the authors recommended continued monitoring and investigation of cementless patellar designs. 119 …”

Section: Patella Resurfacing Managementmentioning

confidence: 99%

Patellar management during total knee arthroplasty: a review

et al. 2021

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The optimal management of the patella during total knee arthroplasty (TKA) remains controversial and surgeons tend to approach the patella with one of three general mindsets: always resurface the patella, never resurface the patella, or selectively resurface the patella based on specific patient or patellar criteria. Studies comparing resurfacing and non-resurfacing of the patella during TKA have reported inconsistent and contradictory findings. When resurfacing the patella is chosen, there are a number of available patellar component designs, materials, and techniques for cutting and fixation. When patellar non-resurfacing is chosen, several alternatives are available, including patellar denervation, lateral retinacular release, and patelloplasty. Surgeons may choose to perform any of these alone, or together in some combination. Prospective randomized studies are needed to better understand which patellar management techniques contribute to superior postoperative outcomes. Until then, this remains a controversial topic, and options for patellar management will need to be weighed on an individual basis per patient. Cite this article: EFORT Open Rev 2021;6:861-871. DOI: 10.1302/2058-5241.6.200156

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Aseptic loosening of the patellar component at the cement–implant interface

Cited by 11 publications

References 18 publications

A Rare Presentation of Patella Button Aseptic Loosening After a Total Knee Replacement Without Evidence of Radiographic Loosening

A Rare Presentation of Patella Button Aseptic Loosening After a Total Knee Replacement Without Evidence of Radiographic Loosening

Loosening of the Patellar Component and Extra-articular and Transcutaneous Migration After TKA

Patellar management during total knee arthroplasty: a review

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