Revision total knee arthroplasty for patellar dislocation in patients with malrotated TKA components
- 5 May 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Archives of orthopaedic and trauma surgery
- Vol. 140 (6), 777-783
- https://doi.org/10.1007/s00402-020-03468-6
Abstract
Purpose Patellar dislocation is a serious complication leading to patient morbidity following total knee arthroplasty (TKA). The cause can be multifactorial. Extensor mechanism imbalance may be present and result from technical errors such as malrotation of the implants. We sought to understand the reasons for post-arthroplasty patellar dislocation and the clinical outcomes of patients in whom it occurs. Methods This is a retrospective cohort study assessing the outcomes of revision surgery for patellar dislocation in patients with component malrotation in both primary and revision TKAs. Patient demographics, dislocation etiology, presurgical deformity, intraoperation component position, complications, reoperation, and Knee Society Scores (KSS) were collected. Results Twenty patients (21 knees) were identified. The average time from primary arthroplasty to onset of dislocation was 33.6 months (SD 44.4), and the average time from dislocation to revision was 3.38 months (SD 2.81). Seventeen knees (80.9%) had internal rotation of the tibial component and seven knees (33.3%) had combined internal rotation of both the femoral and tibial components. Fifteen knees (71.4%) were treated with a condylar constrained implant at the time of revision, and five knees were converted to a hinged prosthesis. The average follow-up time was 56 months. During this time, one patient (4.54%) had a recurrent dislocation episode, requiring further surgery. At final follow up, the mean KSS was 86.2. Conclusion Revision TKA following patellar dislocation for patients with malrotated components was associated with high success rates. After revision surgery, patients had a low recurrence of patellar dislocation, low complication rates, and excellent functional outcomes.Keywords
This publication has 26 references indexed in Scilit:
- Long-Term Survivorship and Clinical Outcomes Following Total Knee ArthroplastyThe Journal of Arthroplasty, 2015
- Phase Transformation Behavior of Ti-10Mo-7Al Alloy with Heat TreatmentJournal of the Japan Institute of Metals and Materials, 2015
- Why Are Total Knee Arthroplasties Failing Today—Has Anything Changed After 10 Years?The Journal of Arthroplasty, 2014
- Medial patellofemoral ligament reconstruction for patellar maltracking following total knee arthroplasty is effectiveKnee Surgery, Sports Traumatology, Arthroscopy, 2012
- Femoral Anterior Tangent Line of the Osteoarthritic Knee for Determining Rotational Alignment of the Femoral Component in Total Knee ArthroplastyThe Journal of Arthroplasty, 2011
- Total knee arthroplasty in severe valgus deformity: Interest of combining a lateral approach with a tibial tubercle osteotomyOrthopaedics & Traumatology: Surgery & Research, 2010
- Kneeling view: A new roentgenographic technique to assess rotational deformity and alignment of the distal femurThe Journal of Arthroplasty, 2003
- Management of recurrent dislocation of the patella following total knee arthroplastyThe Journal of Arthroplasty, 1992
- PATELLA ALTA AND RECURRENT DISLOCATION OF THE PATELLAJournal of Pediatric Orthopaedics, 1992