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- Title
What clinical characteristics and radiographic parameters are associated with patellofemoral instability after kinematically aligned total knee arthroplasty?
- Authors
Nedopil, Alexander; Howell, Stephen; Hull, Maury; Nedopil, Alexander J; Howell, Stephen M; Hull, Maury L
- Abstract
<bold>Introduction: </bold>Thirteen patients presented with patellofemoral instability out of 3212 knees treated with kinematically aligned total knee arthroplasty (KA TKA) during a nine year period. We determined the clinical characteristics and post-operative radiographic parameters associated with patellofemoral instability, and whether re-operation and patient reported outcome measures are different between patients with and without patellofemoral instability.<bold>Methods: </bold>Patients with patellofemoral instability were matched 1:3 to a control cohort based on date of surgery (±3 months), age (±10 years), sex, pre-operative knee deformity (varus or valgus), and implant brand. We analyzed clinical characteristics and seven post-operative radiographic parameters.<bold>Results: </bold>Patellofemoral instability presented atraumatically (12 of 13) at 5 ± 4.7 months for a 0.4 % incidence at a mean follow-up of 43 ± 36 months. No pre-operative clinical characteristics were associated with instability. Patients with patellofemoral instability had greater flexion of the femoral component (11° versus 5°; p = 0.0012), a trend toward greater external rotation of the tibial component (2° versus 0°; p = 0.2704), more reoperations (9 versus 0; p = 0.0026) and a lower Oxford Knee Score (36 versus 42; p = 0.0045) than controls.<bold>Discussion: </bold>Patellofemoral instability after kinematically aligned TKA is infrequent, presents atraumatically, and is associated with greater flexion of the femoral component than the control group.<bold>Conclusion: </bold>Minimizing flexion of the femoral component might reduce the risk of patellofemoral instability by promoting early engagement of the patella in the trochlear during knee flexion.
- Subjects
ARTHROPLASTY; PATELLOFEMORAL joint diseases; RADIOGRAPHIC processing; KNEE abnormalities; FEMUR abnormalities; THERAPEUTICS
- Publication
International Orthopaedics, 2017, Vol 41, Issue 2, p283
- ISSN
0341-2695
- Publication type
journal article
- DOI
10.1007/s00264-016-3287-z