Evidence map›Paper›PMID 39175088›Full record

ArticleKnee surgery & related research2024

Internal rotational patellar resection and patella alta induced patellar maltracking in total knee arthroplasty: intraoperative measurement of the patellofemoral pressure.

Sanshiro Yasuma, Sakurako Kato, Takuya Usami, Yusuke Hattori, Yuji Joyo, Hiroo Shiraga, Masahiro Nozaki, Hideki Murakami, Yuko Waguri-Nagaya

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Article in Knee surgery & related research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Sanshiro YasumaDepartment of Orthopaedic Surgery, Nagoya City University East Medical Center, 2-23 Wakamizu 1, Chikusa, Nagoya, Japan.
Sakurako KatoDepartment of Orthopaedic Surgery, Nagoya City University East Medical Center, 2-23 Wakamizu 1, Chikusa, Nagoya, Japan.
Takuya UsamiDepartment of Orthopaedic Surgery, Nagoya City University East Medical Center, 2-23 Wakamizu 1, Chikusa, Nagoya, Japan.
Yusuke HattoriDepartment of Orthopaedic Surgery, Nagoya City University East Medical Center, 2-23 Wakamizu 1, Chikusa, Nagoya, Japan.
Yuji JoyoDepartment of Orthopaedic Surgery, Nagoya City University East Medical Center, 2-23 Wakamizu 1, Chikusa, Nagoya, Japan.
Hiroo ShiragaDepartment of Orthopaedic Surgery, Nagoya City University East Medical Center, 2-23 Wakamizu 1, Chikusa, Nagoya, Japan.
Masahiro NozakiDepartment of Orthopaedic Surgery, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho, Nagoya, Japan.
Hideki MurakamiDepartment of Orthopaedic Surgery, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho, Nagoya, Japan.
Yuko Waguri-NagayaDepartment of Orthopaedic Surgery, Nagoya City University East Medical Center, 2-23 Wakamizu 1, Chikusa, Nagoya, Japan. waguri@med.nagoya-cu.ac.jp.ORCID http://orcid.org/0000-0002-5690-7731

Funding

Japan Society for the Promotion of Science London 24K19589Nagoya City University 2011101
6 · The paper itself

Abstract

backgroundAnterior knee pain due to patellar maltracking following total knee arthroplasty (TKA) reduces patients' satisfaction. This study aimed to determine the patellofemoral pressure (PFP) in patients with favorable patellar tracking (FT) and impaired patellar tracking (IT) following TKA, the factors causing patellar maltracking, and the effect of lateral retinacular release (LRR) on patients with IT.

methodsForty-four patients with varus knee osteoarthritis undergoing cruciate-retaining TKA were enrolled. After component implantation, patients with a separation of ≥ 2 mm of the patellar medial facet from the medial femoral trochlea throughout knee range of motion were classified into the IT group; meanwhile, the others were classified into the FT group. PFP was measured intraoperatively in three phases: (1) with the resurfaced patella (RP); (2) with the resurfaced patella and knee (RPK); and (3) when LRR was performed in IT (post-LRR). The PFPs at 0°, 90°, 120°, and 135° knee flexion were compared between FT and IT using the Mann-Whitney U test. Pairwise comparison of the PFP in IT between RPK and post-LRR was performed using the Wilcoxon signed-rank test. Correlations between PFP and pre- and postoperative radiographic parameters, such as hip-knee-ankle angle, lateral distal femoral angle, medial proximal tibial angle, anterior femoral offset, Insall-Salvati ratio (ISR), patellar tilt, and patellar resection angle (PRA), were evaluated using Spearman's rank correlation coefficients.

resultsHigh lateral PFP in the knee flexion position led to patellar maltracking. Patients with IT (n = 24) had higher lateral and lower medial PFP than did patients with FT (n = 20) at 90°, 120°, and 135° knee flexion in RP and RPK. LRR in IT reduced the lateral PFP in the knee flexion position. PRA and ISR were correlated with the lateral PFP at no less than 90° in RP and RPK.

conclusionsThis study demonstrated that internal rotational patellar resection, which resulted in a thick medial patellar remnant and a thin lateral counterpart, and patella alta were the causative factors of high lateral PFP, which induced patellar maltracking after TKA. Surgeons should avoid internal rotational patellar resection to achieve FT and perform LRR in patients with patellar maltracking.

Indexed as

Lateral retinacular releasePatellar heightPatellar resection anglePatellar trackingPatellofemoral pressureTotal knee arthroplasty

Identifiers

PMID39175088
PMCPMC11342663

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.