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 Guide Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. TKA Revision Orthobullets Team Recon - High Tibial Osteotomy Technique Guide Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. TKA - Parapatellar Approach Derek T. Bernstein Stephen Incavo Recon - High Tibial Osteotomy Technique Guide Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. TKA - Varus Knee with Anterior Referencing and Gap Balancing Technique Derek T. Bernstein Stephen Incavo Recon - TKA Axial Alignment
QUESTIONS 1 of 4 1 2 3 4 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK This is an AAOS Self Assessment Exam (SAE) question. Orthobullets was not involved in the editorial process and does not have the ability to alter the question. If you prefer to hide SAE questions, simply turn them off in your Learning Goals. (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 Type & Select Correct Answer 1 Slight external rotation of the tibial component 76% (461/609) 2 Slight internal rotation of the femoral component 12% (75/609) 3 Slight anterior translation of the tibial component 2% (15/609) 4 Use of a fixed-bearing knee as opposed to a mobile-bearing knee 3% (18/609) 5 Use of a thicker patellar component 6% (37/609) L 2 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review Tested Concept Review Full Topic This is an AAOS Self Assessment Exam (SAE) question. Orthobullets was not involved in the editorial process and does not have the ability to alter the question. If you prefer to hide SAE questions, simply turn them off in your Learning Goals. (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: A B C Type & Select Correct Answer 1 Hinged knee brace 0% (1/819) 2 Patellar component revision with a tantalum implant and lateralization of the patella 3% (25/819) 3 Revision knee arthroplasty with greater internal rotation of the tibial component 2% (17/819) 4 Revision total knee arthroplasty with a lateral release and external rotation of the femoral component 90% (738/819) 5 Revision total knee arthroplasty with a lateral release and internal rotation of the femoral component 4% (36/819) L 1 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic