TITLE

Patellofemoral Evaluation After Total Knee Arthroplasty

AUTHOR(S)
Baldini, Andrea; Anderson, John A.; Cerulli-Mariani, Pierpaolo; Kalyvas, James; Pavlov, Helene; Sculco, Thomas P.
PUB. DATE
August 2007
SOURCE
Journal of Bone & Joint Surgery, American Volume;Aug2007, Vol. 89-A Issue 8, p1810
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Radiographic assessment of the patella after total knee arthroplasty is typically performed with use of static, unloaded views that may not reproduce the in vivo patellofemoral kinematics. The purpose of the present study was to evaluate and validate the reliability and reproducibility of a weight-bearing radiographic assessment of the patellofemoral joint in patients who have undergone total knee arthroplasty. Methods: Radiographs were made for 100 knees in sixty-nine patients who had undergone total knee arthroplasty. Radiographic assessment of the patellofemoral joint was performed with use of both the standard Merchant axial view and a modification of that view. The Merchant axial view was modified by positioning the standing patient in the semi-squatted position with the knees in 45° of flexion. The relationship between the x-ray source, the angle of incidence on the joint, and the cassette position was kept unchanged from the original view. The standing position and consequent muscle involvement were the only differences. Results: Compared with the standard Merchant axial view, the weight-bearing axial view showed a number of patellofemoral tracking changes. Specifically, lateral tilt and subluxation of the patella were significantly reduced; the rate of exposed, uncovered patellar bone contact with the femoral trochlea was significantly increased; and radiographic evidence of maltracking was more closely correlated with clinical symptoms. Conclusions: An axial weight-bearing radiographic view with the patient in the semi-squatting position was developed to reproduce patellofemoral joint loading. This view demonstrates that the position of the patella, as seen on the standard unloaded Merchant view, changes during squatting. Utilization of this axial weight-bearing view to evaluate total knee arthroplasty may provide additional information over standard radiographic views. Level of Evidence: Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
26180970

 

Related Articles

  • Patellofemoral Arthroplasty: A Systematic Review of the Literature. Tarassoli, Payam; Punwar, Shahid; Khan, Wasim; Johnstone, David // Open Orthopaedics Journal;2012 Special Issue 002, Vol. 6 Issue S2, p340 

    Identification and management of patients with isolated patellofemoral osteoarthritis are challenging. Many of these patients present at a young age and it is important to distinguish degenerative change in the patellofemoral articulation from the other various causes of anterior knee pain. Once...

  • Custom Patellofemoral Arthroplasty of the Knee. Sisto, Domenick J.; Sarin, Vineet K. // Journal of Bone & Joint Surgery, American Volume;2007 Supplement 2, Part 2, Vol. 89-A, p214 

    BACKGROUND: The treatment of isolated patellofemoral arthritis is controversial. Several surgical procedures have been used to treat the severely degenerated patellofemoral joint, with varying degrees of success. The purpose of this study was to determine the clinical results of a custom...

  • Relationship between the surgical epicondylar axis and the articular surface of the distal femur: an anatomic study. Lustig, Sébastien; Lavoie, Frédéric; Selmi, Tarik; Servien, Elvire; Neyret, Philippe // Knee Surgery, Sports Traumatology, Arthroscopy;Aug2008, Vol. 16 Issue 7, p674 

    Many authors presented the epicondylar axis as the fixed axis of rotation of the femoral condyles during flexion of the knee. Positioning of the femoral component of a total knee arthroplasty (TKA) based on the epicondyles has been proposed. This work is a critical analysis of this concept....

  • Secondary Patellar Resurfacing after Primary Bicondylar Knee Arthroplasty did Not Meet Patients' Expectations. Correia, João; Sieder, Marc; Kendoff, Daniel; Citak, Mustafa; Gehrke, Thorsten; Klauser, Wolfgang; Haasper, Carl // Open Orthopaedics Journal;2012, Vol. 6, p414 

    Secondary patella resurfacing is a controversial procedure which is applied in patients with anterior knee pain after a bicondylar knee arthroplasty (with unresurfaced patella). A group of 46 patients were submitted to this procedure and their satisfaction, range of motion and pain improvement...

  • Metal Ion Measurement as a Diagnostic Tool to Identify Problems with Metal-on-Metal Hip Resurfacing. De Smet, K.; De Haan, R.; Calistri, A.; Campbell, P. A.; Ebramzadeh, E.; Pattyn, C.; Gill, H. S. // Journal of Bone & Joint Surgery, American Volume;Nov2008 Supplement 4, Vol. 90-A, p202 

    The article reports on the results of research which was conducted in an effort to determine if measurement of serum ion levels could be used as a diagnostic tool by correlating correlating blood and joint fluid metal ion measurements with findings of metallosis and component wear at the time of...

  • Biomechanical Effects of Kneeling After Total Knee Arthroplasty. Wilkens, Kenneth J.; Duong, Long V.; McGarry, Michelle H.; Kim, William C.; Lee, Thay Q. // Journal of Bone & Joint Surgery, American Volume;Dec2007, Vol. 89-A Issue 12, p2745 

    Background: Kneeling following total knee arthroplasty can be a difficult task, impairing the activities of patients to varying degrees. Little is known about the biomechanical effects of kneeling following total knee replacement. The objective of this study was to quantify the effects of...

  • Patellofemoral replacement resurfaces limited knee area, allows quick recovery. Rapp, Susan M. // Orthopedics Today;Nov2008, Vol. 28 Issue 11, p16 

    The article reports on patellofemoral (PF) arthroplasty in patients suffering from isolated patellofemoral arthritis. According Dr. Ronald P. Grelsamer at the 9th Annual Advances in Arthritis, Arthroplasty and Trau,a Course, performing the procedure presented good outcomes. Survival rates are...

  • Eighteen-year follow-up after rotationplasty for a grade IIIC open fracture of the distal femur. Petri, M.; Omar, M.; Horstmann, H.; Brand, S.; Krettek, C. // Archives of Orthopaedic & Trauma Surgery;Mar2013, Vol. 133 Issue 3, p351 

    We report the 18-year follow-up of a patient who underwent rotationplasty for severe bone loss and infection after an grade IIIC open fracture of the distal femur. The patient is now 49 years old and fully satisfied with his life. During the follow-up period, he has never had significant...

  • PATELLOFEMORAL ARTHRITIS. Grelsamer, Ronald P.; Stein, Drew A. // Journal of Bone & Joint Surgery, American Volume;Aug2006, Vol. 88-A Issue 8, p1849 

    The article discusses the case of a patient with pyknodysostosis who had osteoarthritis of both hips, which were managed with total hip arthroplasty with cement. In 1977, the patient had a low-friction arthroplasty with cement performed on the left hip. In 1984, he had chronic osteomyelitis of...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics