Medial patellofemoral ligament reconstruction for patellar maltracking following total knee arthroplasty is effective

Abstract

IV.

Anterior tibial curved cortex is a reliable landmark for tibial rotational alignment in total knee arthroplasty

“…Although most patients who receive TKA show successful functional outcomes, some patients have persistent knee pain, limited range of motion, and instability after TKA, eventually requiring revision TKA [2–4]. While multiple factors are relevant for achieving successful functional outcomes after TKA, the rotational alignment of the tibial component is particularly important, since malrotation can cause patellar maltracking [5–7], tibiofemoral joint instability in flexion [8–10], and premature wear of the polyethylene components, which eventually affects implant longevity [11–13]. …”

Medial patellofemoral ligament reconstruction for patellar instability following total knee arthroplasty: A review of 6 cases

“…Gennip et al [15] described nine cases of patellar dislocation or subluxation following TKA. Seven of those nine patients underwent preoperative CT scan to determine the implant positioning and TT-TG distance.…”

“…To our knowledge, few cases of this technique being used to realign the patella following TKA have been described [10][11][12][13][14][15].…”

Strategies for Reconstruction of the Medial Patellofemoral Ligament

“…20,24,30 This technique may be of particular importance in situations where patella tunnels and hardware must be avoided, as may occur in cases of revision MPFL reconstruction or patella instability after total knee arthroplasty with a patella component in situ. 59 Regardless of the mode of patella fixation employed, strict attention must be paid to the position of the femoral tunnel and graft tension changes through the range of motion. This should allow one quadrant of lateral displacement at 201-301 and become lax in flexion, the so called "favorable anisometry.…”