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Revision total knee arthroplasty for patellar dislocation in patients with malrotated TKA components

  • Knee Revision Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

Patellar dislocation is a serious complication leading to patient morbidity following total knee arthroplasty (TKA). The cause can be multifactorial. Extensor mechanism imbalance may be present and result from technical errors such as malrotation of the implants. We sought to understand the reasons for post-arthroplasty patellar dislocation and the clinical outcomes of patients in whom it occurs.

Methods

This is a retrospective cohort study assessing the outcomes of revision surgery for patellar dislocation in patients with component malrotation in both primary and revision TKAs. Patient demographics, dislocation etiology, presurgical deformity, intraoperation component position, complications, reoperation, and Knee Society Scores (KSS) were collected.

Results

Twenty patients (21 knees) were identified. The average time from primary arthroplasty to onset of dislocation was 33.6 months (SD 44.4), and the average time from dislocation to revision was 3.38 months (SD 2.81). Seventeen knees (80.9%) had internal rotation of the tibial component and seven knees (33.3%) had combined internal rotation of both the femoral and tibial components. Fifteen knees (71.4%) were treated with a condylar constrained implant at the time of revision, and five knees were converted to a hinged prosthesis. The average follow-up time was 56 months. During this time, one patient (4.54%) had a recurrent dislocation episode, requiring further surgery. At final follow up, the mean KSS was 86.2.

Conclusion

Revision TKA following patellar dislocation for patients with malrotated components was associated with high success rates. After revision surgery, patients had a low recurrence of patellar dislocation, low complication rates, and excellent functional outcomes.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada

    Yaniv Warschawski, Simon Garceau, Omar Dahduli, Jesse Wolfstadt & David Backstein

  2. Orthopedic Department, Rabin Medical Center, Beilinson Hospital, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St., 49100, Petah Tikva, Israel

    Tal Frenkel Rutenberg

Authors
  1. Yaniv Warschawski
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  2. Simon Garceau
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  3. Tal Frenkel Rutenberg
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  4. Omar Dahduli
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  5. Jesse Wolfstadt
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  6. David Backstein
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Correspondence to Yaniv Warschawski.

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Warschawski, Y., Garceau, S., Frenkel Rutenberg, T. et al. Revision total knee arthroplasty for patellar dislocation in patients with malrotated TKA components. Arch Orthop Trauma Surg 140, 777–783 (2020). https://doi.org/10.1007/s00402-020-03468-6

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  • DOI: https://doi.org/10.1007/s00402-020-03468-6

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