Treatment strategy and effect of maltracking of patellofemoral joints in total knee arthroplasty
HUANG Yuan-xia, DUAN Yong-zhuang, WANG Li-min, Xu hai-bin
Chinese Journal of Clinical Anatomy ›› 2017, Vol. 35 ›› Issue (2) : 220-223.
Treatment strategy and effect of maltracking of patellofemoral joints in total knee arthroplasty
Objective To summarize the effect and treatment methods in correcting the maltracking of patellofemoral joints in the total knee arthroplasty (TKA). Methods From June 2012 to December 2014, in 52 patellofemoral maltracking patients (58 knees with TKA ) with patella in lateral dislocation propensity, we used the methods of adjusting the tension between lateral retinaculum and medial retinaculum of patella, patella forming or adjusting the position of the tibial prosthesis properly, or employed two or three methods mentioned above,to correct the maltracking of patellofemoral joints when the TKA was conducted. Results No thumb test was negative in operation, and there was no outward dislocation of the patella after operation. Incisions healed by first intention. in 2 cases, hemarthrosis occurred due to larger-range intraoperative lateral support release in order to correct apparent valgus, which was then managed and relieved with the symptomatic approach. No other complications occurred. All patients were followed up for 17~47 months (32 months on average). Genu valgum or genu varum was not found in all cases, Flexion deformity of knee joints with 5~10° (8°on average) was found in 4 cases. At the end of follow-up, KSS score was 78~89 points, with an average of 84 points, and KSS knee function score was 82~91 points, with an average of 86 points. The X-ray films from the very beginning after surgery to the end of follow-up showed the prosthesis was in a normal position with no signs of loosening or infection. Conclusion In order to correct the maltracking of patellofemoral joints in TKA, releasing lateral retinaculum and tightening medial retinaculum of patella, patella forming and dressing , adjusting the position of the tibial prothesis properly, or employing the two or three kinds of methods mentioned above were efficient methods and beneficial to the recovery of knee joint function after operation.
Total knee arthroplasty / Patellofemoral joint / Medial retinaculum / Lateral retinaculum / Patella forming
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