Symbol: Treatment for patellofemoral maltracking in total knee arthroplasty

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Abstract

BACKGROUND:

The complication of patellofemoral joint is the main cause of anterior knee pain after total knee arthroplasty.

OBJECTIVE:

To explore the strategies and treatment methods of patellofemoral maltracking in total knee arthroplasty.

METHODS:

Thirty-one patients (32 knee joints) had patellofemoral maltracking in total knee arthroplast. All the patients were female, aged 53-85 years old, averaged in 68.5 years old. The course of the disease was 8-25 years (22.3 years on average). Among all the cases, 28 knees of 27 cases were diagnosed as having osteoarthritis, four knees of four cases were rheumatoid arthritis. The valgus angle was 12°-32° (20° on average) and the Q angle was 13°-23° (16° on average). Correct osteotomy and prosthesis position adjustment, balancing soft tissue of lateral and medial side of the patella or Goldthwait-Roux methods were used for correcting patellofemoral maltracking in total knee arthroplasty.

RESULTS AND CONCLUSION:

All the patients were followed-up for 12-120 months postoperatively. Average range of motion of the knee joint was (98.2±10.3)°. The Knee Society Score was increased from preoperative 35 points to postoperative 81 points; and the function score of Knee Society Score was increased from preoperative 34 points to postoperative 83 points. After replacement, all incisions were well-healed by first intension, and complications such as necrosis of the skin and wound infection did not occur. Knutsson X-ray on axial position of the patella for 45° inflexion of the knee was found no tilt, subluxation or dislocation of the patella. For correcting patellofemoral maltracking in total knee arthroplasty, adopting stabilized prosthesis, using osteotomy and adjusting the prosthesis position correctly, balancing soft tissue of lateral and medial side of the patella or Goldthwait-Roux can achieve quite satisfactory results.

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