Patellofemoral Pain After Total Knee Arthroplasty

&NA; The incidence of patellofemoral complications after total knee arthroplasty has been reported to range from 2% to 7%. Such complications include pain, subluxation, dislocation, loosening, and wear. Usually these complications are attributable to prosthetic design or surgical technique. Today, it is understood that patellofemoral prostheses must have a degree of congruence; must allow smooth, not abrupt, motion; and must restore a relatively normal size relationship between the patella and the femur. Surgical technique requires strict attention to (1) restoration of the patellofemoral spacing while avoiding “overstuffing” of the patellofemoral compartment; (2) accurate superior and medial positioning of the patellar component; (3) restoration of the rotational alignment of the femoral and tibial components; and (4) appropriate balancing of the patellofemoral soft tissues.

[1]  G. Scuderi**,et al.  Total knee arthroplasty. Current clinical perspectives. , 1992 .

[2]  J D Reuben,et al.  The effect of femoral component position on the kinematics of total knee arthroplasty. , 1993, Clinical orthopaedics and related research.

[3]  G. Scuderi**,et al.  Patellar fractures in total knee arthroplasty. , 1989, The Journal of arthroplasty.

[4]  E. Fern,et al.  Anterior knee pain in rheumatoid patients after total knee replacement. Possible selection criteria for patellar resurfacing. , 1992, The Journal of bone and joint surgery. British volume.

[5]  K. Vince,et al.  The patella in total knee arthroplasty. , 1992, The Orthopedic clinics of North America.

[6]  J. Insall,et al.  Patellar dislocation following total knee replacement. , 1985, The Journal of bone and joint surgery. American volume.

[7]  C. Ranawat,et al.  The total condylar knee prosthesis. A report of two hundred and twenty cases. , 1979, The Journal of bone and joint surgery. American volume.

[8]  F F Buechel,et al.  A metal-backed, rotating-bearing patellar prosthesis to lower contact stress. An 11-year clinical study. , 1989, Clinical orthopaedics and related research.

[9]  M. Freeman,et al.  The patellofemoral joint in total knee prostheses , 1989 .

[10]  T P Andriacchi,et al.  Patellar component failure in cementless total knee arthroplasty. , 1988, Clinical orthopaedics and related research.

[11]  G. Scuderi**,et al.  The relationship of lateral releases to patella viability in total knee arthroplasty. , 1987, The Journal of arthroplasty.

[12]  J. Reuben,et al.  Effect of patella thickness on patella strain following total knee arthroplasty. , 1991, The Journal of arthroplasty.

[13]  R E Booth,et al.  The patellar "clunk" syndrome after posterior stabilized total knee arthroplasty. , 1994, Clinical orthopaedics and related research.

[14]  L. Whiteside,et al.  The effects of axial rotational alignment of the femoral component on knee stability and patellar tracking in total knee arthroplasty demonstrated on autopsy specimens. , 1993, Clinical orthopaedics and related research.

[15]  Total knee arthroplasty : current clinical perspectives : Hip and knee implant fixation and wear , 1992 .

[16]  V. Goldberg,et al.  The effect of alignment of the implant on fractures of the patella after condylar total knee arthroplasty. , 1989, The Journal of bone and joint surgery. American volume.

[17]  A. Tria,et al.  Patellar fractures in posterior stabilized knee arthroplasties. , 1994, Clinical orthopaedics and related research.

[18]  R. Scott,et al.  Total knee arthroplasty without patellar resurfacing. Clinical outcomes and long-term follow-up evaluation. , 1993, Clinical orthopaedics and related research.

[19]  R E Jensen,et al.  A comparison of contact pressures in tibial and patellar total knee components before and after service in vivo. , 1994, Clinical orthopaedics and related research.

[20]  J. Rand.  The patellofemoral joint in total knee arthroplasty. , 1994, The Journal of bone and joint surgery. American volume.

[21]  R. Bourne,et al.  Management of recurrent dislocation of the patella following total knee arthroplasty. , 1992, The Journal of arthroplasty.

[22]  R. Bourne,et al.  Cancellous Bone Support for Patellar Resurfacing , 1987, Clinical orthopaedics and related research.

[23]  S. Stern,et al.  Total knee arthroplasty in obese patients. , 1990, The Journal of bone and joint surgery. American volume.

[24]  Ff Beuchel.  A metal-backed rotating bearing patella prosthesis to lower contact stress , 1989 .

[25]  D. Lyttle,et al.  Surgical interruption of patellar blood supply by total knee arthroplasty. , 1988, Clinical orthopaedics and related research.

[26]  L. Dorr,et al.  Patellar tilt and subluxation in total knee arthroplasty. Relationship to pain, fixation, and design. , 1993, Clinical orthopaedics and related research.

[27]  Docteur Paul G. J. Maquet,et al.  Biomechanics of the Knee , 1984, Springer Berlin Heidelberg.

[28]  G. Scuderi**,et al.  Scintigraphic determination of patellar viability after excision of infrapatellar fat pad and/or lateral retinacular release in total knee arthroplasty. , 1990, Clinical orthopaedics and related research.

[29]  M. Freeman,et al.  The patellofemoral joint in total knee prostheses. Design considerations. , 1989, The Journal of arthroplasty.

[30]  V. Goldberg,et al.  Patellar fracture type and prognosis in condylar total knee arthroplasty. , 1988, Clinical orthopaedics and related research.

[31]  L. Whiteside,et al.  The effect of patellar button placement and femoral component design on patellar tracking in total knee arthroplasty. , 1992, Clinical orthopaedics and related research.

[32]  A H Burstein,et al.  The posterior stabilized condylar prosthesis: a modification of the total condylar design. Two to four-year clinical experience. , 1982, The Journal of bone and joint surgery. American volume.