Osteoarthritis with permanent dislocation of the patella treated by total knee arthroplasty through a lateral approach: A report of two cases

Abstract

HighlightsPermanent dislocation of the patella (PDP) is a rare condition. In cases of PDP with tibiofemoral arthritis, total knee arthroplasty may be performed through a medial parapatellar approach with patellar realignment in general.We performed two total knee arthroplasties for PDP with lateral tibiofemoral arthritis through a lateral approach without any realignment procedure.We only have 2 cases, but we suggest that TKA through a lateral approach have potential to be a new treatment option to achieve both a good outcome and repositioning of the patella.

Knee osteoarthritis with patellar dislocation treated by total knee arthroplasty using a lateral parapatellar approach—ingenuity of exposure and closure

“…However, MPFLR and tibial tubercle osteotomy have been added to most cases, and the degree of lateral release and the methods of exposure and closure remain unknown [7]. Fujiwara et al reported a case similar to ours that could be treated simply with TKA using a lateral approach [8]. However, they only described the closure method as follows: "The gap of the lateral capsule is to be covered by soft tissue such as the infrapatellar fat pad or the lateral meniscus" [8].…”

“…Fujiwara et al reported a case similar to ours that could be treated simply with TKA using a lateral approach [8]. However, they only described the closure method as follows: "The gap of the lateral capsule is to be covered by soft tissue such as the infrapatellar fat pad or the lateral meniscus" [8].…”

“…There have been only a few reports of knee OA with PD that was simply treated with TKA with a lateral parapatellar approach [ 7 , 8 ]. Most cases were treated with TKA combined with various realignment methods of the extensor mechanism, such as proximal realignment [ 1 ], medial patellofemoral ligament reconstruction (MPFLR) [ 2 ], and tibial tubercle osteotomy [ 3 ].…”

Total Hip Arthroplasty Concomitant with Patellofemoral Arthroplasty and Medial Patellofemoral Ligament Reconstruction for a Patient with Patellar Dislocation Combined with Hip Dysplasia: A Case Report of a Successful Outcome at 5-Year Follow-Up

“…Some studies reported successful clinical cases of patellar dislocation treated by TKA with vastus medialis advancement [6][7][8][9]. Matsushita et al reported satisfactory outcomes of TKA combined with MPFL reconstruction for patients with chronic patellar dislocation with valgus deformity of 3 Case Reports in Orthopedics the knee [14].…”

“…The increased femoral anteversion angle (FAA) has been reported as a risk factor of patellofemoral incongruity and patellar dislocation, because the internal torsion on the distal femur lateralizes the patellar joint and persistent force leads to increased pressure on the PF joint [3,4]. Recently, there have been reports of patellar dislocation with PF osteoarthritis treated by total knee arthroplasty (TKA) [5][6][7][8][9]. However, it is controversial to perform TKA on a knee without tibiofemoral (TF) joint OA.…”