Updated: 6/11/2021

TKA Patellar Maltracking

0%
Topic
Review Topic
0
0
N/A
N/A
Questions
4
0
0
0%
0%
Evidence
4
0
0
0%
Techniques
3
Topic
  • Summary
    • TKA Patellar Maltracking is a common cause of patient dissatisfaction following TKA and is the most common reason for secondary surgery following total knee arthroplasty.
    • Diagnosis is made clinically with a combination of anterior knee pain, patellar subluxation during ambulation, and limitation in knee flexion.
    • Treatment may be nonoperative or operative depending on underlying etiology.
  • Epidemiology
    • Incidence
      • most common reason for secondary surgery following total knee arthroplasty
  • Etiology
    • Causes
      • may be related to
        • prosthetic design
        • extensor mechanism imbalance
        • asymmetric patellar resection
        • malrotation
        • patellar malpositioning
  • Presentation
    • Symptoms
      • complaints may include
        • feelings of subluxation
        • frank dislocation
        • peri-patellar pain
        • limited flexion
  • Imaging
    • Radiographs
      • recommended views
        • AP
          • used to assess placement of femoral component and Q angle
        • lateral
          • used to assess size and rotation of femoral component
        • tangential
          • used to assess subluxation of patella, placement of patellar component, angle of patellar resection, and patellar tilt
      • findings
        • laterally subluxed patella
        • increased Q angle
        • anterior placement of femoral component
        • asymmetric patellar resection
        • lateral placement of paellar component
        • lateral osteophyte on patella
    • CT
      • best to assess for rotational malalignment
  • Treatment
    • Must appropriately address etiology
Technique Guides (3)
Flashcards (0)
Cards
1 of 0
Questions (4)
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK

(SAE07HK.83) During total knee arthroplasty, the patella is noted to subluxate laterally despite a lateral retinacular release. Which of the following methods is most likely to improve patellar stability?

QID: 6043
1

Slight external rotation of the tibial component

76%

(431/570)

2

Slight internal rotation of the femoral component

12%

(71/570)

3

Slight anterior translation of the tibial component

3%

(15/570)

4

Use of a fixed-bearing knee as opposed to a mobile-bearing knee

3%

(16/570)

5

Use of a thicker patellar component

6%

(34/570)

L 2 E

Select Answer to see Preferred Response

(SAE07HK.11) A 64-year-old man undergoes a primary total knee arthroplasty. Three months after surgery he reports persistent pain, weakness, and difficulty ambulating. Postoperative radiographs are shown in Figures 6a through 6c. What is the best course of action at this time?

QID: 5971
FIGURES:
1

Hinged knee brace

0%

(1/812)

2

Patellar component revision with a tantalum implant and lateralization of the patella

3%

(25/812)

3

Revision knee arthroplasty with greater internal rotation of the tibial component

2%

(17/812)

4

Revision total knee arthroplasty with a lateral release and external rotation of the femoral component

90%

(731/812)

5

Revision total knee arthroplasty with a lateral release and internal rotation of the femoral component

4%

(36/812)

L 1 E

Select Answer to see Preferred Response

Evidence (4)
EXPERT COMMENTS (0)
Private Note