Osteonecrosis of the patella and prosthetic extrusion after total knee arthroplasty

Noorpuri, B.S.W.; Maqsood, M.

doi:10.1054/arth.2002.33270

Cited by 22 publications

(11 citation statements)

References 3 publications

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“…Ritter et al 8 reported significantly higher occurrence rate of patellofemoral complications after total knee arthroplasty with lateral retinacular release comparing those without lateral retinacular release. There have been a few case reports of patellar osteonecrosis after TKA with lateral retinacular release 9 . However, to the best of our knowledge, there has been no report of patellar osteonecrosis after TKA without lateral retinacular release.…”

Section: Discussionmentioning

confidence: 92%

Osteonecrosis of bipartite patella following total knee arthroplasty without lateral release

Noh

Roh

2019

Acta Orthopaedica et Traumatologica Turcica

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We present a case of osteonecrosis of bipartite patella occurring after total knee arthroplasty using medial parapatellar approach without lateral retinacular release in osteoarthritic knee of a 66 year-old-male. The surgery was performed using traditional technique with medial parapatellar approach and patella was resurfaced. Patella was everted during surgery. There was no event during follow-up period after surgery. Range of motion of the knee was 135° without flexion contracture. Eight months after the surgery, patella was fragmented and resorbed on the radiographs which was consistent with osteonecrosis. The patient showed extension limitation of 30° with no pain. Patellar osteonecrosis has been rarely reported after total knee arthroplasty with lateral retinacular release. However, there was no report of patellar osteonecrosis after total knee arthroplasty without lateral retinacular release. Caution should be taken about patellar osteonecrosis in case of bipartite patella even though lateral retinaculum is preserved during total knee arthroplasty.

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Section: Discussionmentioning

confidence: 92%

Osteonecrosis of bipartite patella following total knee arthroplasty without lateral release

Noh

Roh

2019

Acta Orthopaedica et Traumatologica Turcica

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“…Another concern is the potential for osteonecrosis of the patella due to the extensive release of the extensor mechanism3, 6 with transection of the lateral geniculate arteries (superior and inferior) or due to medial parapatellar approach, which separates the vastus medialis from the patella and results in the loss of the vascular supply by the medial geniculate arteries (superior and inferior) or descending geniculate artery 1 . In our case we performed the subvastus approach, which permits preservation of the descending geniculate artery, similar that previously described by In et al, 1 associated with a controlled lateral release, achieving an adequate patellar tracking.…”

Section: Discussionmentioning

confidence: 99%

“…Noorpuri and Maqsood 6 found a patellar necrosis seven years after a TKA and Helito et al 9 reported a migrated patella nine years after TKA, that is why surgeons must do a periodic radiographic control of these patients.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical reconstruction can be technically demanding and requires attention to restoring the extensor mechanism realignment, soft tissue balancing, good patellar tracking, as well as correction of the bony deformities present in the severe valgus knee 2, 5. Another concern is about the potential for osteonecrosis of the patella due to disruption of its blood supply during medial parapatellar approach and when performing extensive lateral release of the extensor mechanism 1, 3, 6…”

Section: Introductionmentioning

confidence: 99%

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Total knee arthroplasty with subvastus approach in patient with chronic post-traumatic patellar dislocation

Junqueira

Helito

Bonadio

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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Chronic lateral dislocation of the patella is a rare condition and acquired causes are usually secondary to knee trauma. The neglected chronic dislocation leads to progressive genu valgum and external tibial torsion deformities with subsequent gonarthrosis, which becomes painful and debilitating. There is no consensus regarding treatment of these patients, but total knee arthroplasty (TKA) is a useful therapy in cases of painful symptomatic gonarthrosis. Few reports have shown that subvastus approach and lateral release may be a valid option for TKA, since it allows the correction of valgus deformity and patellar tracking without interrupting vascular blood supply of patella. This article reports a case of TKA and extensor mechanism realignment without patellar resurfacing in a patient with genu valgum and chronic post-traumatic patellar dislocation with satisfactory results after two years of follow-up.

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“…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. This report is unique because, during the primary procedure, no lateral release was performed and no patellar necrosis was evident on radiographs.…”

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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Osteonecrosis of the patella and prosthetic extrusion after total knee arthroplasty

Cited by 22 publications

References 3 publications

Osteonecrosis of bipartite patella following total knee arthroplasty without lateral release

Osteonecrosis of bipartite patella following total knee arthroplasty without lateral release

Total knee arthroplasty with subvastus approach in patient with chronic post-traumatic patellar dislocation

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

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