Patellofemoral complications following total knee arthroplasty

Healy, William L.; Wasilewski, Stephen A.; Takei, Robert; Oberlander, Michael A.

doi:10.1016/s0883-5403(05)80127-5

Cited by 206 publications

(54 citation statements)

References 29 publications

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“…Both uncemented and metal-backed patellar components were used. In contrast to our report, Healy et al [11] reported osteoarthritis associated with patellar component failure as compared to other diagnoses. Windsor et al [35] noted patients with postoperative knee flexion of greater than 95°had an increased risk of patellar fracture.…”

Section: Resultscontrasting

confidence: 99%

“…Specific patient factors such as gender, BMI, coronal alignment, and preoperative flexion were all important factors in patellar component failure. Healy et al [11] in a study evaluating 211 TKAs reported obesity (mean weight, 190 pounds or greater) was associated with an increased incidence of patellofemoral problems. Both uncemented and metal-backed patellar components were used.…”

Section: Resultsmentioning

confidence: 99%

“…However, not resurfacing the patella has generally been associated with more anterior knee pain, more weakness, and more revision operations [6,12,23,24,27]. Historically, several factors have been associated with patellar failure, including patient factors (osteoarthritis [11], obesity [11], and increased postoperative flexion [15,35]), surgeon factors (increasing the relative patellar thickness [13,15,32] and performing a lateral retinacular release [4,21,29,32]), and prosthetic factors (the use of metal-backed patellae [3,30,34] and the use of a large central peg [10,19,28,31]). Because of this dilemma, selected patellar resurfacing may be desirable.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predicting Patellar Failure After Total Knee Arthroplasty

Meding

Fish

Berend

et al. 2008

Clinical Orthopaedics &Amp; Related Research

104

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Section: Resultscontrasting

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predicting Patellar Failure After Total Knee Arthroplasty

Meding

Fish

Berend

et al. 2008

Clinical Orthopaedics &Amp; Related Research

104

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“…Patellofemoral (PF) joint complications continue to account for a significant percentage (up to 10%) of total knee replacement (TKR) revisions (Healy et al, 1995; Dalury et al, 2003; Rhee et al, 2008). Pathologies such as patellar subluxation and maltracking are characterized by medial-lateral (ML) translation and internal-external rotation of the patella (Singerman et al, 1997; Kawano et al, 2002) and remain a common cause of TKR revisions (D’Lima et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Statistical shape modeling predicts patellar bone geometry to enable stereo-radiographic kinematic tracking

Smoger

Shelburne

Cyr

et al. 2017

Journal of Biomechanics

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Complications in the patellofemoral (PF) joint of patients with total knee replacements include patellar subluxation and dislocation, and remain a cause for revision. Kinematic measurements to assess these complications and evaluate implant designs require the accuracy of dynamic stereo-radiographic systems with 3D-2D registration techniques. While tibiofemoral kinematics are typically derived by tracking metallic implants, PF kinematic measurements are difficult as the patellar implant is radiotransparent and a representation of the resected patella bone requires either pre-surgical imaging and precise implant placement or post-surgical imaging. Statistical shape models (SSMs), used to characterize anatomic variation, provide an alternative means to obtain the representation of the resected patella for use in kinematic tracking. Using a virtual platform of a stereo-radiographic system, the objectives of this study were to evaluate the ability of an SSM to predict subject-specific 3D implanted patellar geometries from simulated 2D image profiles, and to formulate an effective data collection methodology for PF kinematics by considering accuracy for a variety of patient pose scenarios. An SSM of the patella was developed for 50 subjects and a leave-one-out approach compared SSM-predicted and actual geometries; average 3D errors were 0.45±0.07 mm (mean ± standard deviation), which is comparable to the accuracy of traditional segmentation. Further, initial imaging of the patella in five unique stereo radiographic perspectives yielded the most accurate representation. The ability to predict the remaining patellar geometry of the implanted PF joint with radiographic images and SSM, instead of CT, can reduce radiation exposure and streamline in vivo kinematic evaluations.

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“…In fact, up to 41.1% of patients have been found to experience patellofemoral complications related to these modifiable elements [9,10] . Causes of patellofemoral complications include rotational errors of the femoral or tibial component, implant maltracking, patellar fracture, aseptic loosening, and polyethylene wear [5,10,11] . Addressing the prosthetic causes of TKA failure will allow improvements to be made in implant design which may result in a decreased incidence of revision surgery and a lessened economic burden for both the patient and the healthcare system.…”

Section: Introductionmentioning

confidence: 99%

Anterior knee pain following primary total knee arthroplasty

Shervin¹,

Pratt²,

Healey³

et al. 2015

WJO

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Despite improvements in technique and technology for total knee arthroplasty (TKA), anterior knee pain impacts patient outcomes and satisfaction. Addressing the prosthetic and surgical technique related causes of pain after TKA, specifically as it relates to anterior knee pain, can aid surgeons in addressing these issues with their patients. Design features of the femoral and patellar components which have been reported as pain generators include: Improper femoral as well as patellar component sizing or designs that result in patellofemoral stuffing; a shortened trochlear groove distance from the flange to the intercondylar box; and then surgical technique related issues resulting in: Lateral patellar facet syndrome; overstuffed patella/ flange combination; asymmetric patellar resurfacing, improper transverse plane component rotation resulting in patellar subluxation/tilt. Any design consideration that allows impingement of extensor mechanism anatomical elements has the possibility of impacting outcome by becoming a pain generator. As the number of TKA procedures continues to increase, it is increasingly critical to develop improved, evidence based prostheses that maximize function and patient satisfaction while minimizing pain and other complications. MINIREVIEWSSubmit a

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Patellofemoral complications following total knee arthroplasty

Cited by 206 publications

References 29 publications

Predicting Patellar Failure After Total Knee Arthroplasty

Predicting Patellar Failure After Total Knee Arthroplasty

Statistical shape modeling predicts patellar bone geometry to enable stereo-radiographic kinematic tracking

Anterior knee pain following primary total knee arthroplasty

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