Article

The patella in revision total knee arthroplasty.

Department of Orthopaedic Surgery, Rush Medical College, Chicago, IL 60612-3828, USA.
The Journal of Bone and Joint Surgery (impact factor: 3.27). 02/2003; 85-A Suppl 1:S63-70. pp.S63-70
Source: PubMed
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    Article: Arthrofibrosis and patella infera: a simple surgical solution. Preliminary report and literature review
    Manuel Villanueva, Ríos Javier Antonio, Jack Pereiro, Homid Davis, Fahandezh, A Rios, J Pereiro, J Davis, H Fahandezh
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    ABSTRACT: Treatment of patella infera and arthrofibrosis after total knee replacement (TKR) remains an unsolved problem. Different options have been proposed: patel-lectomy, proximal transposition of tibial tuberosity, distalization of the femoral component, arthroscopic and open debridment of intraarticular fibrosis. Individ-ual predisposition, mechanical irritation due to technical errors and an aggressive rehabilitation program have been all related as predisposing or causative factors. We present one patient with patella baja and arthrofibrosis with progressive retraction of patellar tendon treated with open arthrolysis and resection of the distal third of the patella in order to lengthen the tendon and pros-thetic resurfacing of the remaining two proximal thirds of the patella. Insall-Salvati, Blackburne and Caton in-dexes were measured from post-operative X-rays after primary surgery to assess that the cause was not an initial component malposition, before and after our revision procedure. Fibrose articulaire et patella baja. Une solution chirurgicale simple Résumé Le traitement des patella baja et des capsulites apres arthroplastie totale de genou reste un probleme non résolu. Différentes solutions ont été proposées: patellectomie, transposition proximale de la tubérosité tibiale antérieure, distalisation du composant fémoral, arthroscopie et débridement intraarticulaire. Prédispo-sition individuelle, erreurs techniques a l'origine d'irri-tations mécaniques, rééducation aggressive sont les facteurs prédisposants ou responsables mis en cause. Nous présentons le cas d'un patient présentant une patella baja avec retraction capsulaire et retraction progressive du tendon patellaire, que nous avons traitée par arthrolyse chirurgicale, résection du tiers distal de la patella de maniere a allonger le tendon, et resurfac;:age prothétique des deux tiers proximauxde la patella. Les index d'Insall-Salvati, de Blackburne et de Caton ont été mesurés sur les clichés post-opératoires initiaux, ainsi que sur les radiographies pré et post révision.
    European Journal of Orthopaedic Surgery & Traumatology 01/2005; 15:350-354. · 0.10 Impact Factor
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Aaron G Rosenberg