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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 2021년 33권 1호 p.9 ~ 9
노정호, 김남엽, 송기일,
소속 상세정보
노정호 ( Noh Jung-Ho ) - Kangwon National University School of Medicine Department of Orthopaedic Surgery
김남엽 ( Kim Nam-Yeop ) - Kangwon National University Hospital Department of Orthopaedic Surgery
송기일 ( Song Ki-Ill ) - Kangwon National University Hospital Department of Orthopaedic Surgery

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?
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.

키워드

Patella; Total knee arthroplasty; Cruciate retaining; Tracking

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