The incidence of the patellar clunk syndrome in a recently designed mobile-bearing posteriorly stabilised total knee replacement

Abstract

The patellar clunk syndrome describes painful catching, grinding or jumping of the patella when the knee moves from a flexed to an extended position after total knee replacement (TKR). The posterior stabilised TKR had been noted to have a higher incidence of this problem. Mobile-bearing posteriorly stabilised TKRs have been introduced to improve patellar tracking and related problems by a mechanism of self-alignment. We evaluated the patellar clunk syndrome in 113 knees in 93 patients with such a TKR at a mean follow-up of 2.3 years (2.0 to 3.2). The syndrome was identified in 15 knees (13.3%). Logistic regression analysis showed that the absolute value of the post-operative angle of patellar tilt was significantly associated with the occurrence of patellar clunk (p = 0.025). Patellar tracking should be carefully checked during surgery.

Incidence and Reasons for Nonrevision Reoperation After Total Knee Arthroplasty

“…Our analysis provides an incidence of 2.3% of knees having a NRR for stiffness. Reported incidence of patellar clunk syndrome after TKA varies widely (0%-13.3%) and depends upon femoral component design [1,2,4,6,9,12]. The incidence reported here (0.5%) suggests an improvement in component design and technique.…”

“…Reoperations may include manipulation under anesthesia (MUA), irrigation and débridement (I&D), arthroscopy, open reduction internal fixation (ORIF), and others. While incidences of individual complications requiring such reoperations have been reported [1,2,4,6,7,9,11,12,14,21,25,29] (Table 1), the comprehensive profile of indications for nonrevision reoperation (NRR) following primary TKA is unreported. Knowledge of the incidence, indication, timing, and predictors of NRR will allow for an efficient use of resources in targeting the most common causes for reoperation, continuing research in preventing these complications, and identifying patients at the greatest risk so preventative measures may be taken.…”

Tibial Tubercle Osteotomy or Quadriceps Snip in Two-stage Revision for Prosthetic Knee Infection? A Randomized Prospective Study

“…2, Ethicon, Somerville, MA, USA). Tension in the repaired quadriceps mechanism and patellar tracking were verified by cycling the knee through ROM according to the no-thumb technique to exclude patellar clunk [1,35,74]. A lateral release was required in 20 patients.…”

“…4), compressing the osteotomy to the cortical bone, to resist lateral dislocation during flexion. The no-thumb technique was used to check patellar tracking and exclude patellar clunk [1,35,74]. A lateral release was performed in 23 patients.…”

Patello-femoral clunk syndrome-current concepts

“…Mobilebearing posteriorly stabilised TKRs have been introduced to improve patellar tracking and related problems by a mechanism of self-alignment. 8 While patella clunk syndrome and patellofemoral crepitus are separate entities, they share a common pathophysiology with widely varying clinical presentations. The symptoms range from a painless subtle crepitation to a painful, palpable and audible clunk.…”