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Exponent, Philadelphia, Pennsylvania, USA
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The management of the patella during total knee arthroplasty (TKA) has been a matter of considerable debate in the orthopaedic community. 1 – 4 Surgeons tend to approach the patella with one of three general mindsets: always resurface the patella
Università degli Studi di Pavia, Pavia, Lombardy, Italy
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Introduction The variability in the decision about whether to resurface the patella in total knee replacement (TKR) is influenced by different factors including geographic location, training of surgeons, implant design and level of constraint
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–flexion–external rotation, occurs in more than 80% of primary patellar dislocations. Spontaneous patellar dislocation is common in skeletally immature girls, and locked dislocation is common in skeletally mature men. 4 Many patients report that they felt the patella
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relevant study comparing conservative treatment with a cylinder cast, brace and posterior splint was available. 3 Anatomy and pathophysiology The patellofemoral joint consists of the patella and the femoral trochlea. This joint obtains its
Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Bologna (BO), Italy
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Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Bologna (BO), Italy
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Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Bologna (BO), Italy
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Introduction Trochlear dysplasia is defined as a geometrical abnormality of the shape and depth of the trochlear groove mainly at its proximal part, where the patella engages into the trochlea. This represents the main feature of the wider and
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, difficulty walking and/or pain. Its incidence is reported to be between 0.1% and 2.5% in all TKA but revision TKA is thought to carry a higher risk. 1 – 4 Extensor mechanism failure can present as quadriceps tendon rupture, patella fracture ( Fig. 1
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technique mainly consists of a through-knee amputation (considered as an AKA by some authors because of the supracondylar amputation level at the distal femur) with the creation of a pedicled patella flap consisting of the patella, patellar ligament, and
Department of Orthopaedic Surgery, University of Cape Town, SA
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as the Freeman-Swanson Total Condylar Prosthesis (1970) and the Kodama-Yamamoto prosthesis (1970), paved the way for future designs, yet the original versions made no allowance for the patella. 14 , 15 Patellectomy was frequently performed either
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Patellar instability is an important cause of knee disability in children and adolescents. A recent population-based study found an annual incidence rate of 2.58 per 100 000 individuals for lateral patella dislocations (LPD), with higher rates in
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bluntly and continued to the joint line to establish the medial gutter. This is repeated on the lateral side, with the pseudocapsule bluntly dissected, fibrous tissue removed from around the patella and any fibrous adhesions deep to the patella released