Patellar tilt and subluxation following subvastus and parapatellar approach in total knee arthroplasty

Bindelglass, David F.; Vince, Kelly G.

doi:10.1016/s0883-5403(96)80101-x

Cited by 94 publications

(38 citation statements)

References 12 publications

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“…We took pre-and serial postoperative radiographs, including standing scanograms, true lateral radiographs, and Merchant's views, to assess the overall tibiofemoral alignment and the position and placement of the patella button. The assessment of the axial patellofemoral position was after Bindelglass and Vince [2], and the method of joint line measurement was after Figgie [4]. Only a brief period of conservative treatment was employed since past results of conservative treatment were disappointing [1].…”

Section: Methodsmentioning

confidence: 99%

Comparison of two total knee prostheses on the incidence of patella clunk syndrome

2002

International Orthopaedics (SICOT)

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The patella clunk syndrome is not an uncommon complication, particularly after posterior-stabilized (PS) total knee arthroplasty. The present study was a consecutive unselected series comparing the incidence of the patella clunk syndrome amongst two comparable groups of elderly patients with knee arthritis implanted with the Insall-Burstein (IB II) total knee system and the newer NexGen Legacy total knee prosthesis. While 7.5% of patients in the PS IB II group developed patella clunk syndrome, none occurred in the NexGen group (P=0.05). We believe the difference is due mainly to a change in the design of the prosthesis, especially the more posterior intercondylar box and femoral cam of the NexGen femoral component.Résumé Le ressaut patellaire audible (clunk syndrome) n'est pas une complication rare en particulier après arthroplastie total du genou postéro -stabilisée (PS). La présente étude est celle d'une série consécutive de patients non sélectionnés comparant la fréquence de ce syndrome parmi deux groupes comparables de malades âgés avec arthrose du genou traités par prothèse de Insall-Bustein (IB II) ou par prothèse NexGen Legacy. Pendant que 7.5% de malades avaient un «clunk syndrome» dans le groupe IB II, aucun ne s'est produit dans le groupe NexGen (P=0.05). Nous croyons que la différence est principalement due à un changement dans le dessin de la prothèse, notamment un boitier intercondylien et une came fémorale plus postérieurs pour la prothèse Nexgen.

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Section: Methodsmentioning

confidence: 99%

Comparison of two total knee prostheses on the incidence of patella clunk syndrome

2002

International Orthopaedics (SICOT)

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“…Two of these are of special interest: a sub-vastus or "southern" approach in which the medial vastus is split and thus the integrity of the quadriceps tendon is preserved, and a lateral approach, which is indicated for patients with a significant valgus deformity [1,11].…”

Section: Introductionmentioning

confidence: 99%

The midvastus surgical approach in total knee arthroplasty

Maestro

Suarez

Rodríguez

et al. 2000

International Orthopaedics

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We report a study of 2 surgical approaches to the knee in 42 consecutive patients undergoing a total arthroplasty. They were divided into 2 groups. In Group 1 (n=17) the knee was exposed through classic medial parapatellar arthrotomy and in Group 2 (n=25) the knee was approached through the fibers of the medial vastus. Preoperative assessment did not reveal any statistical differences between the groups, and blood loss, operation time, biochemistry values and radiographic evaluation were also similar. However, a higher number of lateral releases, a loss of knee extension and a reduced range of motion were significantly associated with classical parapatellar arthrotomy. As the number of operative or postoperative complications was not increased, we recommend the mid-vastus approach for total knee arthroplasty.Résumé Nous présentons une étude de 42 arthroplasties totales consécutives de genoux qui ont été divisées en deux groupes. Le groupe 1 (n=17) a eu une voie d'abord classique par arthrotomie antéro-interne parapatellaire et le groupe 2 (n=25) a eu un abord à travers les fibres du vastus medialis. Entre les deux groupes, il n'y a pas de différence significative entre les données pré-opératoires, la perte sanguine, le temps opératoire et l'état radiographique. Dans le groupe 1, un plus grand nombre de libé-rations externes a été nécessaire, une perte de la force d'extension a été notée ainsi qu'une diminution de l'amplitude articulaire. Comme le taux de complications opé-ratoires et postopératoires n'a pas été majoré, nous recommandons ce type d'approche à travers les fibres du vastus medialis pour l'arthroplastie totale de genou.

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“…The same authors using the same methods but a different implant design reported a higher incidence of medial patellar tilt [26]. With the standard surgical approach, 2% had with a postoperative lateral patellar tilt (N5°), 22% had a postoperative medial patellar tilt (N5°), and 31% had a lateral postoperative patellar shift (N5 mm).…”

Section: Discussionmentioning

confidence: 92%

“…Although it is known that TKA itself alters the biomechanics of the knee and that component design and proper component alignment are essential to minimize the risk of patellar complications [25][26][27][28], there is not much information available about the specific role of the lateral patellar retinaculae or how their tensions might be affected by prosthetic design. It has been shown recently that lateral release can allow the patella to be displaced laterally by a significantly reduced force in a normal knee in vitro [29].…”

Section: Discussionmentioning

confidence: 99%

“…The "no-thumb" technique is often used to assess patellar tracking before closure of the capsule during TKA, but it has been suggested that assessment of tracking with the medial incision left open may overestimate the need for lateral retinacular release [26,32]. These authors described the use of a towel clip to attach the medial retinaculum to the patella when assessing patella tracking.…”

Section: Discussionmentioning

confidence: 99%

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A Technique of Staged Lateral Release to Correct Patellar Tracking in Total Knee Arthroplasty

Strachan

Merican

Devadasan³

et al. 2009

The Journal of Arthroplasty

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Patellar tilt and subluxation following subvastus and parapatellar approach in total knee arthroplasty

Cited by 94 publications

References 12 publications

Comparison of two total knee prostheses on the incidence of patella clunk syndrome

Comparison of two total knee prostheses on the incidence of patella clunk syndrome

The midvastus surgical approach in total knee arthroplasty

A Technique of Staged Lateral Release to Correct Patellar Tracking in Total Knee Arthroplasty

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