Intraoperative patellar maltracking and postoperative radiographic patellar malalignment were more frequent in cases of complete medial collateral ligament release in cruciate-retaining total knee arthroplasty
Abstract Background Patellar maltracking after total knee arthroplasty (TKA) can lead to significant patellofemoral complications such as anterior knee pain, increased component wear, and a higher risk of component loosening, patellar fracture, and instability. This study was to investigate the preo...
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doaj-c5a87faa2fce4e7dbfa3b9ad7763d0072021-03-21T12:52:17ZengBMCKnee Surgery & Related Research2234-24512021-03-013311810.1186/s43019-021-00091-6Intraoperative patellar maltracking and postoperative radiographic patellar malalignment were more frequent in cases of complete medial collateral ligament release in cruciate-retaining total knee arthroplastyJung Ho Noh0Nam Yeop Kim1Ki Ill Song2Department of Orthopaedic Surgery, Kangwon National University School of MedicineDepartment of Orthopaedic Surgery, Kangwon National University HospitalDepartment of Orthopaedic Surgery, Kangwon National University HospitalAbstract Background Patellar maltracking after total knee arthroplasty (TKA) can lead to significant patellofemoral complications such as anterior knee pain, increased component wear, and a higher risk of component loosening, patellar fracture, and instability. This study was to investigate the preoperative and operative variables that significantly affect patellar tracking after cruciate-retaining TKA. Methods We studied 142 knee joints in patients who had undergone TKA: the knees were dichotomized based on postoperative patellar tracking, which was evaluated on patellar skyline, axial-projection radiographs: group 1, normal patellar tracking (lateral tilt ≤ 10° and displacement ≤ 3 mm) and group 2, patellar maltracking (lateral tilt > 10° or displacement > 3 mm). The patients’ demographic data and clinical and radiographic measurements obtained before and after surgery were compared between the two groups. Results Preoperative lateral patellar displacement was greater (4.1 ± 2.6 mm vs. 6.0 ± 3.5 mm), as was the frequency of medial collateral ligament (MCL) release (3/67 vs. 24/75) in group 2 than in group 1 (p < 0.001 and p < 0.001, respectively). The distal femur was cut in a greater degree of valgus in group 1 than in group 2. (6.3 ± 0.8° vs. 6.0 ± 0.8°) (p = 0.034). Conclusions Complete release of the MCL during surgery was associated with patellar maltracking (logistic regression: p = 0.005, odds ratio = 20.592). Surgeons should attend to patellar tracking during surgery in medially tight knees. Level of evidence Retrospective comparative study, level III.https://doi.org/10.1186/s43019-021-00091-6PatellaTotal knee arthroplastyCruciate retainingTracking |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jung Ho Noh Nam Yeop Kim Ki Ill Song |
spellingShingle |
Jung Ho Noh Nam Yeop Kim Ki Ill Song Intraoperative patellar maltracking and postoperative radiographic patellar malalignment were more frequent in cases of complete medial collateral ligament release in cruciate-retaining total knee arthroplasty Knee Surgery & Related Research Patella Total knee arthroplasty Cruciate retaining Tracking |
author_facet |
Jung Ho Noh Nam Yeop Kim Ki Ill Song |
author_sort |
Jung Ho Noh |
title |
Intraoperative patellar maltracking and postoperative radiographic patellar malalignment were more frequent in cases of complete medial collateral ligament release in cruciate-retaining total knee arthroplasty |
title_short |
Intraoperative patellar maltracking and postoperative radiographic patellar malalignment were more frequent in cases of complete medial collateral ligament release in cruciate-retaining total knee arthroplasty |
title_full |
Intraoperative patellar maltracking and postoperative radiographic patellar malalignment were more frequent in cases of complete medial collateral ligament release in cruciate-retaining total knee arthroplasty |
title_fullStr |
Intraoperative patellar maltracking and postoperative radiographic patellar malalignment were more frequent in cases of complete medial collateral ligament release in cruciate-retaining total knee arthroplasty |
title_full_unstemmed |
Intraoperative patellar maltracking and postoperative radiographic patellar malalignment were more frequent in cases of complete medial collateral ligament release in cruciate-retaining total knee arthroplasty |
title_sort |
intraoperative patellar maltracking and postoperative radiographic patellar malalignment were more frequent in cases of complete medial collateral ligament release in cruciate-retaining total knee arthroplasty |
publisher |
BMC |
series |
Knee Surgery & Related Research |
issn |
2234-2451 |
publishDate |
2021-03-01 |
description |
Abstract Background Patellar maltracking after total knee arthroplasty (TKA) can lead to significant patellofemoral complications such as anterior knee pain, increased component wear, and a higher risk of component loosening, patellar fracture, and instability. This study was to investigate the preoperative and operative variables that significantly affect patellar tracking after cruciate-retaining TKA. Methods We studied 142 knee joints in patients who had undergone TKA: the knees were dichotomized based on postoperative patellar tracking, which was evaluated on patellar skyline, axial-projection radiographs: group 1, normal patellar tracking (lateral tilt ≤ 10° and displacement ≤ 3 mm) and group 2, patellar maltracking (lateral tilt > 10° or displacement > 3 mm). The patients’ demographic data and clinical and radiographic measurements obtained before and after surgery were compared between the two groups. Results Preoperative lateral patellar displacement was greater (4.1 ± 2.6 mm vs. 6.0 ± 3.5 mm), as was the frequency of medial collateral ligament (MCL) release (3/67 vs. 24/75) in group 2 than in group 1 (p < 0.001 and p < 0.001, respectively). The distal femur was cut in a greater degree of valgus in group 1 than in group 2. (6.3 ± 0.8° vs. 6.0 ± 0.8°) (p = 0.034). Conclusions Complete release of the MCL during surgery was associated with patellar maltracking (logistic regression: p = 0.005, odds ratio = 20.592). Surgeons should attend to patellar tracking during surgery in medially tight knees. Level of evidence Retrospective comparative study, level III. |
topic |
Patella Total knee arthroplasty Cruciate retaining Tracking |
url |
https://doi.org/10.1186/s43019-021-00091-6 |
work_keys_str_mv |
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