Scintigraphic Assessment of Patellar Viability in Total Knee Arthroplasty After Lateral Release

Pawar, Uday; Rao, K. N.; Sundaram, PShanmuga; Thilak, Jai; Varghese, Jacob

doi:10.1016/j.arth.2008.02.017

Cited by 46 publications

(22 citation statements)

References 10 publications

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“…In the presence of severe medial patellar articular lesions a LRR may increase the load to the defect which may be detrimental. Pawar et al [63] have recently raised awareness by documenting the great incidence of transient patellar hypovascularity associated with lateral release on a prospective study of knees undergoing total knee replacement with lateral retinacular release.…”

Section: Lateral Retinacular Release (Lrr)mentioning

confidence: 99%

The Operative Management of Patella Malalignment

Iliadis¹,

Jaiswal²,

Khan³

et al. 2012

TOORTHJ

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Management of patellofemoral joint pathology is challenging as a result of the unique and complex organization of static forces and dynamic factors contributing to its functional capacity. Anterior knee pain is a common musculoskeletal complaint seen daily in the practices of primary care physicians, rheumatologists, and orthopedic surgeons. The key to successful treatment lies not only in the correct diagnosis of a chondral defect, but more importantly, in the accurate identification of associated pathomechanical factors. Appreciating the pathoanatomic basis of the disease and addressing imbalances and anatomical abnormalities should guide treatment.Despite the complexity of the interplay of various components it is essential to attempt to describe patellar malalignement as a clinical entity in order to proceed with appropriate surgical management and successful outcomes. The goals of patellofemoral re- alignment surgery should be to create both a stable environment for optimal extensor mechanism performance and an appropriate load transmission for optimal cartilage wear and joint loading. In the context of this article we will review the operative management of patellofemoral malalignment; the indications for surgery, the different techniques available and the evidence regarding their effectiveness.A large number of procedures have been employed and they have all undergone various modifications over the course of the years. The majority of publications are retrospective series in poorly defined population groups. There are significant methodological inconsistencies and as a result there is lack of strong evidence base for the majority of these procedures.

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Section: Lateral Retinacular Release (Lrr)mentioning

confidence: 99%

The Operative Management of Patella Malalignment

Iliadis¹,

Jaiswal²,

Khan³

et al. 2012

TOORTHJ

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“…This increased blood loss was associated with a large increase in transfusion requirement, and this should be of concern since blood transfusion is associated with several important complications including transfusion reactions, haemolysis and infection transmission [9]. This increased blood loss is also of concern since it may reflect damage to the vascular supply to the patella which has been of major concern after LR [ [10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 96%

Predictors and outcomes of lateral release in total knee arthroplasty: A cohort study of 1859 knees

Molyneux

Brenkel

2012

The Knee

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“…These three knees did not use LRR, so the result implies that devascularization is not the only factor leading to patellar avascular necrosis. Pawar et al 30 reported that although LRR influences the blood supply of the patella, it is transient. The blood supply to the patella can recover to a near-normal value at 8 weeks, 30 which may be the reason that none of the patients exhibited patellar avascular necrosis in this study.…”

Section: Discussionmentioning

confidence: 99%

Results of Lateral Retinacular Release Plus Circumpatellar Electrocautery in Total Knee Arthroplasty without Patellar Resurfacing

2016

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Anterior knee pain (AKP) is integral to the overall success of total knee arthroplasty (TKA) without patellar resurfacing. Numerous studies have evaluated various factors that may contribute to AKP, including patellofemoral design, surgical technique, characteristics of the patient, and degree of chondromalacia. This study aims to explore whether patients who received lateral retinacular release (LRR) plus circumpatellar electrocautery (CE) in TKA attain a low incidence of AKP and whether the LRR plus CE increases postoperative complications. Between February 2001 and February 2009, all patients undergoing TKA without patellar resurfacing and LRR plus CE were evaluated. In total, 286 TKAs in 259 (88.7%) patients were available for assessment, with a mean of 9.3 ± 2.5 years (range: 6-14 years) after the index TKA. The patients were evaluated with a VAS and the Kujala patellofemoral score (KPS) for AKP and the Knee Society's clinical scoring system (KSS) for the clinical function. Satisfaction and LRR-related complications were also assessed. The mean KPS and KSS improved from 45.2 ± 12.9 and 75.4 ± 26.8 points preoperatively to 82.8 ± 10.0 and 151.6 ± 17.3 points at the final follow-up ( < 0.001), respectively. Subjectively, 5.6% (16 of 286) of patients suffered from AKP and 88.1% (252 of 286) were satisfied or very satisfied. Postoperative complications occurred in 15 (5.2%) patients, but these complications were mild and did not require reoperation. None of patients exhibited aseptic and septic prosthesis loosening and required revision surgery in the final follow-up. LRR plus CE appears to be a reasonable option in TKA without patellar resurfacing. It may achieve adequate mid-term results, with a low incidence of AKP and postoperative complications.The level of evidence of the study is therapeutic level IV.

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Scintigraphic Assessment of Patellar Viability in Total Knee Arthroplasty After Lateral Release

Cited by 46 publications

References 10 publications

The Operative Management of Patella Malalignment

The Operative Management of Patella Malalignment

Predictors and outcomes of lateral release in total knee arthroplasty: A cohort study of 1859 knees

Results of Lateral Retinacular Release Plus Circumpatellar Electrocautery in Total Knee Arthroplasty without Patellar Resurfacing

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