Updated: 9/6/2018

TKA Patellar Maltracking

Topic
Review Topic
0
0
Questions
5
0
0
Evidence
3
0
0
Techniques
3
Introduction
  • Epidemiology
    • most common reason for secondary surgery following total knee arthroplasty
  • 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
 

Please rate topic.

Average 3.9 of 9 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Technique Guides (3)
Questions (5)
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

You have 100% on this question.
Just skip this one for now.

(SAE07HK.95) A patient with a valgus knee and lateral compartment bone loss undergoes a total knee arthroplasty using posterior condylar referencing instrumentation. Six months after surgery, the patient reports significant anterior knee pain, and radiographs reveal severe lateral patellar tilt. Management should consist of Review Topic

QID: 6055
1

lateral retinacular release.

18%

(80/446)

2

femoral component revision.

75%

(335/446)

3

medialization of the patellar component.

4%

(18/446)

4

patellectomy.

0%

(0/446)

5

tibial tubercle transfer.

2%

(9/446)

L 2

Select Answer to see Preferred Response

SUBMIT RESPONSE 2

You have 100% on this question.
Just skip this one for now.

(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? Review Topic

QID: 6043
1

Slight external rotation of the tibial component

81%

(182/225)

2

Slight internal rotation of the femoral component

8%

(17/225)

3

Slight anterior translation of the tibial component

3%

(6/225)

4

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

1%

(3/225)

5

Use of a thicker patellar component

7%

(15/225)

L 2

Select Answer to see Preferred Response

SUBMIT RESPONSE 1

You have 100% on this question.
Just skip this one for now.

(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? Review Topic

QID: 5971
FIGURES:
1

Hinged knee brace

0%

(0/490)

2

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

2%

(10/490)

3

Revision knee arthroplasty with greater internal rotation of the tibial component

2%

(8/490)

4

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

92%

(449/490)

5

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

4%

(21/490)

L 1

Select Answer to see Preferred Response

SUBMIT RESPONSE 4
ARTICLES (3)
Topic COMMENTS (0)
Private Note