–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.
Many patients report that they felt the patella
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
Francesco BenazzoSezione di Chirurgia Protesica ad Indirizzo Robotico – Unità di Traumatologia dello Sport, U.O Ortopedia e Traumatologia Fondazione Poliambulanza, Brescia, Lombardy, Italy Università degli Studi di Pavia, Pavia, Lombardy, Italy
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
relevant study comparing conservative treatment with a cylinder cast, brace and posterior splint was available.
Anatomy and pathophysiology
The patellofemoral joint consists of the patella and the femoral trochlea. This joint obtains its
Giulio Maria Marcheggiani MuccioliIstituto Ortopedico Rizzoli, Dipartimento Rizzoli Sicilia, Bagheria (PA), Italy Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Bologna (BO), Italy
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
, 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
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
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
Many patients present to orthopaedic surgeons with a painful knee attributed to osteoarthritis of the medial compartment, where the lateral compartment and patella-femoral joint are relatively spared. Traditionally, the treatment
prosthetic surgery. There are several publications on PCS rates with various designs. The symptoms are secondary to the formation of a fibrous nodule in the upper pole of the patella that collides with the femoral shield when extending the knee. Patients