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Computer-Assisted Navigation in Patellofemoral Arthroplasty: a New Technique to Improve Rotational Position of the Trochlea

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HSS Journal ®

Abstract

Background

Maltracking or subluxation is one of the complications of patellofemoral arthroplasty.

Questions/Purposes

We questioned whether the computed navigation system can improve patellar tracking in patients with patellofemoral arthroplasty (PFA).

Methods

Between 2007 and 2010 we performed 15 patellofemoral arthroplasties using the Ceraver PFA and navigation assistance. Fifteen other patients underwent surgery without navigation during the same period and acted as a control group. The rotation of the native trochlea as measured using the epicondylar line as a reference before surgery and the rotation of the trochlear component and the trochlear twist angle were assessed with computed tomography (CT) scan after surgery.

Results

The mean follow-up was 3 years (range, 2–5 years). The group with navigation had no patellofemoral complications and better clinical scores. The group without navigation had abnormal patellofemoral tracking in 5 of the 15 patients. CT scan demonstrated excessive internal component rotation, as compared with patients without complications. This excessive internal rotation was proportional to the severity of the patellofemoral maltracking.

Conclusions

The short-term results suggest that navigation can lead to better trochlear rotation which, in our hands, is associated with fewer cases of patellar maltracking and better overall clinical scores.

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Disclosures

Conflict of Interest:

Philippe Hernigou, MD, Charles Henri Flouzat-Lachaniette, MD, William Delblond, MD, Pascal Duffiet MD, Didier Julian declare that they have no conflict of interest.

Human/Animal Rights:

All procedures followed were in accordance with the ethical standards of the responsible commiee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent:

Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Hospital Henri Mondor, Avenue du Marechal de Lattre de Tassigny, Creteil, 94000, France

    Philippe Hernigou MD, Charles Henri Flouzat-Lachaniette MD, William Delblond MD, Pascal Duffiet MD & Didier Julian MD

  2. University Paris East, 61 Avenue du Général de Gaulle, Creteil, 94010, France

    Philippe Hernigou MD, Charles Henri Flouzat-Lachaniette MD, William Delblond MD, Pascal Duffiet MD & Didier Julian MD

Authors
  1. Philippe Hernigou MD
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  2. Charles Henri Flouzat-Lachaniette MD
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  3. William Delblond MD
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  4. Pascal Duffiet MD
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  5. Didier Julian MD
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Corresponding author

Correspondence to Philippe Hernigou MD.

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Level of Evidence:

Therapeutic Study Level III. Please see levels of evidence for a complete description.

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Hernigou, P., Flouzat-Lachaniette, C.H., Delblond, W. et al. Computer-Assisted Navigation in Patellofemoral Arthroplasty: a New Technique to Improve Rotational Position of the Trochlea. HSS Jrnl 9, 118–122 (2013). https://doi.org/10.1007/s11420-013-9328-x

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  • DOI: https://doi.org/10.1007/s11420-013-9328-x

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