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When performing a total knee arthroplasty on a 60-year-old female patient, a surgeon chooses not to resurface the patella. Instead, he performs a patelloplasty by excising the marginal osteophytes and reshaping the patella. All of the following statements comparing the results of patelloplasty to patella resurfacing are true EXCEPT:
There is no difference in relative risk of anterior knee pain.
There is no difference in relative risk for revision surgery involving the tibial and femoral components.
There is an increased risk that she will need secondary resurfacing.
No difference in rates of patellar avascular necrosis or patellar tendon injury.
Total knee arthroplasty improved function regardless of whether the patella was resurfaced.
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Which of the following intra-operative errors most commonly leads to patellar maltracking during a total knee arthroplasty?
Using the gap balancing technique instead of measured resection technique
Internal rotation of the femoral component
External rotation of the tibial component
Lateralization of the femoral prosthesis
Overresection of the patella
Which of the following intra-operative steps would put a patient at risk for lateral patellar maltracking during total knee arthroplasty (TKA)?
External rotation of the femoral component
Medial placement of the patellar component
Internal rotation of the tibial component
Lateral translation of the femoral component
Superior placement of the patellar component
Internal rotation of the femoral component in primary total knee arthroplasty may lead to which of the following?
A net lateral patellar tilt and increased lateral subluxation
A decreased Q angle
A loose medial compartment and tight lateral compartment
Balanced medial and lateral flexion gaps
Following a left total knee arthroplasty, all of the following can cause the condition seen in Figure A EXCEPT:
Internal rotation of the femoral prosthesis
Internal rotation of the tibial prosthesis
Medialization of the tibial prosthesis
Lateralization of the patellar prosthesis
A 66-year-old woman with genu valgum osteoarthritis undergoes total knee replacement. What technical error could lead to post-operative lateral patellar instability?
Lateralization of the femoral component
Medialization of the patellar component
A standard total knee is performed on a 56 year-old female using spinal anesthesia and a tourniquet. After cementation of all the components, the patella is noted to sublux laterally during range of motion. The alignment and rotation of the femoral, tibial, and patellar components all appear perfect. The surgeon should now:
Perform a lateral release
Revise tibial component into more external rotation
Revise the femoral component into more external rotation
Revise the patellar component to a more medial position on the native patella
Reevaluate patellar tracking after deflation of the tourniquet
Which of the following aids in correction of patellar tracking after total knee arthroplasty (TKA)?
Internal rotation of the tibial component
Increasing size of the tibial component
Joint line elevation
The posterior condylar axis may be used to determine the rotation of the femoral component in total knee arthroplasty. Which of the following describes the normal relation of the posterior condylar axis?
Parallel to the transepicondylar axis
Perpendicular to the anteroposterior axis (Whiteside's line)
3 degrees externally rotated to the transepicondylar axis
3 degrees internally rotated to the transepicondylar axis
7 degrees externally rotated to the transepicondylar axis
Failure to identify a hypoplastic lateral condyle in a valgus knee will result in which of the following errors if a posterior condylar referencing guide is used for total knee arthroplasty?
Internal rotation of the tibial and femoral components
Internal rotation of the femoral component during total knee arthroplasty can result in which of the following?
Increased need for lateral release
Decreased post-operative pain
Increased polyethylene thickness
Decreased post-operative Q angle
Elevation of the native joint line
Malrotation of total knee components leading to patellar tracking problems is best diagnosed by what radiographic modality?
3-joint standing x-rays
dynamic examination under anesthesia with fluoroscopy
CT scan of the knee
45 degree flexed PA x-rays of the knee
magnetic resonance arthrogram of the knee
Which of the following factors MOST places the knee at risk of patellar maltracking in total knee arthroplasty?
Thickness of patellar resection
Cruciate retaining component
Medial placement of patellar component
Preoperative patellar tilt
Lateral placement of patellar component
Which of the following intra-operative techniques during total knee arthroplasty (TKA) decreases the need for lateral retinacular release?
Internal rotation of femoral component
External rotation of femoral component
Internal rotation of tibial component
Lateralization of patellar component
Insertion of a posterior cruciate retaining device