Does malrotation of components correlate with patient dissatisfaction following secondary patellar resurfacing?

Bhattee, Ghias; Moonot, Pradeep; Govindaswamy, Raj; Pope, Andrew J.; Fiddian, N. J.; Harvey, Adrian R.

doi:10.1016/j.knee.2012.12.006

Cited by 56 publications

(45 citation statements)

References 28 publications

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“…The complexity of patellofemoral joint and the high number of pain transmitters are of relevance to the issue of whether or not to resurface the patella, which is an area of ongoing controversy in the field of TKA [1,3,4,7,14,17,24,33,34] . If the patella is resurfaced, the articular cartilage is removed and substituted with a polyethylene component.…”

Section: Pathophysiology and Etiology Of Painmentioning

confidence: 99%

“…Tibia-femoral instability, due to inappropriate placement or other causes, leads to increased pressure on the PFJ, especially in flexion [54] . However, perhaps the most important aspect of placement is the influence of malrotation after TKA [8,9,18,34,[55][56][57] . Berger et survive the wallerian degeneration, but also proliferate and form rows along the course previously taken by the axons [35] .…”

Section: Regeneration Of Nervesmentioning

confidence: 99%

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Anterior knee pain after a total knee arthroplasty: What can cause this pain?

Breugem¹,

Haverkamp²

2014

WJO

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Total Knee Arthroplasty has been shown to be a successful procedure for treating patients with osteoarthritis, and yet approximately 5%-10% of patients experience residual pain, especially in the anterior part of the knee. Many theories have been proposed to explain the etiology of this anterior knee pain (AKP) but, despite improvements having been made, AKP remains a problem. AKP can be described as retropatellar or peripatellar pain, which limits patients in their everyday lives. Patients suffering from AKP experience difficulty in standing up from a chair, walking up and down stairs and riding a bicycle. The question asked was: "How can a 'perfectly' placed total knee arthroplasty (TKA) still be painful: what can cause this pain?". To prevent AKP after TKA it is important to first identify the different anatomical structures that can cause this pain. Greater attention to and understanding of AKP should lead to significant pain relief and greater overall patient satisfaction after TKA. This article is a review of what pain is, how nerve signalling works and what is thought to cause Anterior Knee Pain after a Total Knee Arthroplasty.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words:Anterior knee pain; Patellofemoral pain; Total knee arthroplasty; Malrotation; Homeostasis Core tip: Total knee arthroplasty (TKA) has been shown to be a successful procedure for treating patients with osteoarthritis, and yet approximately 5%-10% of patients experience anterior knee pain (AKP). To prevent AKP after TKA it is important to first identify the different anatomical structures that can cause this pain. Greater attention to and understanding of AKP should lead to significant pain relief and greater overall patient satisfaction after TKA. This article is a review of what pain is, how nerve signalling works and what is thought to cause AKP after a TKA.Breugem SJM, Haverkamp D. Anterior knee pain after a total knee arthroplasty: What can cause this pain? World

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Section: Pathophysiology and Etiology Of Painmentioning

confidence: 99%

Section: Regeneration Of Nervesmentioning

confidence: 99%

Anterior knee pain after a total knee arthroplasty: What can cause this pain?

Breugem¹,

Haverkamp²

2014

WJO

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“…Although some have noted that a neutral postoperative mechanical alignment defined as a dichotomous variable is not predictive of survivorship, the gold standard remains neutral postoperative mechanical alignment [7,25,39]. Although ideal sagittal alignment is mostly unknown [32], there is evidence that rotational malalignment should be avoided [4]. Innovations including navigation and patientspecific instrumentation have been introduced to theoretically improve the accuracy of alignment obtained with conventional instrumentation [11,14,35,40].…”

Section: Introductionmentioning

confidence: 99%

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Pfitzner

Abdel

Roth

et al. 2014

Clinical Orthopaedics &Amp; Related Research

101

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Background Patient-specific instrumentation in TKA has the proposed benefits of improving coronal and sagittal alignment and rotation of the components. In contrast, the literature is inconsistent if the use of patient-specific instrumentation improves alignment in comparison to conventional instrumentation. Depending on the manufacturer, patient-specific instrumentation is based on either MRI or CT scans. However, it is unknown whether one patient-specific instrumentation approach is more accurate than the other and if there is a potential benefit in terms of reduction of duration of surgery. Questions/purposes We compared the accuracy of MRIand CT-based patient-specific instrumentation with conventional instrumentation and with each other in TKAs. The three approaches also were compared with respect to validated outcomes scores and duration of surgery. Methods A randomized clinical trial was conducted in which 90 patients were enrolled and divided into three groups: CT-based, MRI-based patient-specific instrumentation, and conventional instrumentation. The groups were not different regarding age, male/female sex distribution, and BMI. In all groups, coronal and sagittal alignments were measured on postoperative standing long-leg and lateral radiographs. Component rotation was measured on CT scans. Clinical outcomes (Knee Society and WOMAC scores) were evaluated preoperatively and at a mean of 3 months postoperatively and the duration of surgery was analyzed for each patient. MRI-and CT-based patientspecific instrumentation groups were first compared with conventional instrumentation, the patient-specific instrumentation groups were compared with each other, and all three approaches were compared for clinical outcome measures and duration of surgery. Results Compared with conventional instrumentation MRI-and CT-based patient-specific instrumentation showed higher accuracy regarding the coronal limb axis

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“…Different studies [76][77][78] confirmed that an internally rotated femoral or tibial component can be related to lateral tilt angle and excessive lateralization of the patellar component, resulting in a painful TKA. An internal rotation of 3°to 7°i s sufficient to cause chronic pain in TKA [69,79].…”

Section: Component Malrotationmentioning

confidence: 99%

Painful knee arthroplasty: current practice

Cottino

Rosso

Pastrone

et al. 2015

Curr Rev Musculoskelet Med

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Primary total knee arthroplasty is the treatment for end-stage arthritis of the knee; in the last years, it is becoming more common and reliable, due to technical and implant improvement. With larger implant rates, the overall complications will increase and pain is the most common sign of implant failure. Pain can be related to a lot of different clinical findings, and the surgeon has to be aware of the various etiologies that can lead to failure. Pain does not always mean revision, and the patient has to be fully evaluated to have a correct diagnosis; if surgery is performed for the wrong reason, this will surely lead to a failure. In this paper, the authors revised the more common causes of failure that can have a painful onset proposing an approach for diagnosis and treatment.

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Does malrotation of components correlate with patient dissatisfaction following secondary patellar resurfacing?

Cited by 56 publications

References 28 publications

Anterior knee pain after a total knee arthroplasty: What can cause this pain?

Anterior knee pain after a total knee arthroplasty: What can cause this pain?

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Painful knee arthroplasty: current practice

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