Combined Total Knee Arthroplasty and Medial Patellofemoral Ligament Reconstruction for Chronic Patellar Dislocation and Severe Osteoarthritis

García-Mansilla, Ignacio; Jones, Kristofer J.; Sassoon, Adam

doi:10.1016/j.artd.2020.11.024

Cited by 3 publications

(5 citation statements)

References 26 publications

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“…However, various methods have been reported. Most cases might be treated with TKA combined with various realignment procedures [ [1] , [2] , [3] ]. Currently, knee OA with PD can be treated simply by performing TKA using the lateral parapatellar approach.…”

Section: Discussionmentioning

confidence: 99%

“…There have been only a few reports of knee OA with PD that was simply treated with TKA with a lateral parapatellar approach [ 7 , 8 ]. Most cases were treated with TKA combined with various realignment methods of the extensor mechanism, such as proximal realignment [ 1 ], medial patellofemoral ligament reconstruction (MPFLR) [ 2 ], and tibial tubercle osteotomy [ 3 ]. We also reported a case of TKA with proximal realignment [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…We also reported a case of TKA with proximal realignment [ 9 ]. Realignment procedures require rehabilitation restrictions [ [1] , [2] , [3] ] and may result in complications [ 4 , 5 ]. As valgus deformity is a typical form of knee OA with PD [ 10 ], the lateral parapatellar approach is, theoretically, suitable for such cases.…”

Section: Discussionmentioning

confidence: 99%

“…Knee osteoarthritis (OA) with patellar dislocation (PD) is a rare condition that is difficult to treat. There have been some reports of total knee arthroplasty (TKA) combined with various realignment procedures [ [1] , [2] , [3] ], which may require rehabilitation restrictions and may cause complications [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Knee osteoarthritis with patellar dislocation treated by total knee arthroplasty using a lateral parapatellar approach—ingenuity of exposure and closure

et al. 2021

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Knee osteoarthritis with patellar dislocation is a rare and difficult-to-treat condition. Several reports of total knee arthroplasty (TKA) combined with various realignment procedures have been published. A 77-year-old man with knee pain was referred to our hospital. Plain radiography revealed a laterally dislocated patella, with osteoarthritic changes in the femorotibial joint. He simply underwent TKA via a lateral parapatellar approach without realignment. We devised methods of exposure and closure to maximize the effect of lateral release by the lateral parapatellar approach. TKA using the lateral parapatellar approach might be effective in treating knee osteoarthritis with patellar dislocation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Knee osteoarthritis with patellar dislocation treated by total knee arthroplasty using a lateral parapatellar approach—ingenuity of exposure and closure

et al. 2021

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“…In addition to pain, knee osteoarthritis can also lead to muscle contracture around the joint, exion deformity, valgus deformity, patellar dislocation, and so on 4,5 . Knee osteoarthritis with patellar dislocation will increase the di culty of TKA, especially in patients with permanent patellar dislocation [6][7][8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Transposition of the medial synovial flap to repair the lateral joint capsule in total knee arthroplasty for knee osteoarthritis with permanent patellar dislocation

Tao

Liu

Wang

et al. 2023

Preprint

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Purpose To retrospectively review the early- and medium-term clinical outcomes of lateral capsulorrhaphy by medial synovial flap transposition in total knee arthroplasty for the treatment of knee osteoarthritis with permanent dislocation of the patella. Method To surgically restore the patellar trajectory in 29 patients with knee osteoarthritis associated with permanent patellar dislocation undergoing total knee arthroplasty using medial synovial flap transposition to repair the lateral joint capsule. Preoperative and 2-year postoperative conditions and knee mobility were compared using the American Knee Society score function score, UCLA activity scale score, and visual analogue (VAS) pain scores. The patients were examined radiographically for full-length knee and axial patellar reduction while standing on both lower limbs. Result The patients' American Knee Society function scores improved from 40.2 ± 12.1 preoperatively to 80.5 ± 7.3 at 2 years postoperatively (P < 0.001), and their UCLA activity class scores improved from 3.9 ± 0.6 preoperatively to 6.8 ± 0.7 at 2 years postoperatively (P < 0.001). VAS pain scores decreased from 41.8 ± 6.0 points preoperatively to 10.1 ± 3.7 at two years postoperatively (P < 0.001). Knee mobility improved from 74.6 ± 8.9 degrees preoperatively to 110.5 ± 4.5 degrees at two years postoperatively (P < 0.001), and imaging showed no signs of subluxation or dislocation of the patella in any of the patients. Conclusions The correction of the patellar trajectory in patients with osteoarthritis with permanent patellar dislocation undergoing total knee arthroplasty using medial synovial flap transposition to repair the lateral joint capsule can lead to satisfactory early and medium-term clinical results.

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Artroplastia total de rodilla en luxación inveterada de patela: Reporte de un caso

Vicuña,

Mendez,

Orrego

et al. 2024

Revista Chilena de Ortopedia y Traumatología

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Resumen Introducción La luxación patelar inveterada (LPI) asociada a artrosis es un problema infrecuente y de difícil manejo, especialmente en pacientes con síndrome de Down (SD). La alteración crónica del funcionamiento patelofemoral (PF) debido a un severo mal alineamiento conduce a una progresiva destrucción articular que puede culminar en artrosis tricompartimental. Se han descrito distintas técnicas para su resolución, desde procedimientos en partes blandas hasta el uso de prótesis total de rodilla (PTR). Presentación del caso Hombre de 29 años con SD consultó por un año de gonalgia derecha atraumática, asociado a episodios de derrame articular. Inicialmente, se diagnosticó como artritis séptica. El examen físico mostró hiperlaxitud (Beighton 8), marcha claudicante, LPI, genu valgo irreductible y artrosis tricompartimental con genu valgo de 13,3° a derecha. Se trató con una PTR y realineamiento del aparato extensor mediante alargamiento del retináculo lateral y avance del vasto medial oblicuo (VMO) con técnica de Insall. A los 8 meses postoperatorios, el paciente está sin dolor, sin nuevos episodios de luxación patelar y es independiente para las actividades básicas de la vida diaria. Discusión Se trata de un caso complejo de gonartrosis e inestabilidad patelar asociado a genu valgo, en un paciente con SD e hiperlaxitud. Junto con la LPI, enfrentamos un valgo de 13,3° y artrosis tricompartimental. Se planificó una PTR primaria estabilizada posterior (PS) con posibilidad de mayor constricción intraoperatoria, junto con realineamiento de partes blandas. La literatura demuestra que este paso es esencial para restaurar la biomecánica PF y lograr buena funcionalidad.

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Combined Total Knee Arthroplasty and Medial Patellofemoral Ligament Reconstruction for Chronic Patellar Dislocation and Severe Osteoarthritis

Cited by 3 publications

References 26 publications

Knee osteoarthritis with patellar dislocation treated by total knee arthroplasty using a lateral parapatellar approach—ingenuity of exposure and closure

Knee osteoarthritis with patellar dislocation treated by total knee arthroplasty using a lateral parapatellar approach—ingenuity of exposure and closure

Transposition of the medial synovial flap to repair the lateral joint capsule in total knee arthroplasty for knee osteoarthritis with permanent patellar dislocation

Artroplastia total de rodilla en luxación inveterada de patela: Reporte de un caso

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