Abstract
Purpose
Patella maltracking is among the most frequent causes of poor outcomes and early failure after total knee arthroplasty (TKA), with an incidence that ranges from 1 to 20%. Even if there is agreement between authors regarding the preoperative and intraoperative management of patella maltracking in TKA, less clear are postoperative conducts. The purpose of this systematic review is to summarize and compare surgical techniques used to treat patella maltracking after TKA.
Methods
A systematic review of the literature was performed with a primary search on Medline through PubMed. The PRISMA 2009 flowchart and checklist were used to edit the review. Screened studies had to provide clinical, functional and radiological results and complications of the proposed treatment to be included in the review.
Results
A total of 21 articles were finally included. Three main types of surgical procedures and other minor techniques have been identified to manage patella maltracking after TKA. The choice of the proper technique to use in the specific case depends on several factors, first of all the malpositioning of the prosthetic components.
Conclusion
Patella maltracking after TKA represents a frequent and challenging problem for orthopedic surgeons. Treatments described in the literature are often able to correct an abnormal patellar tracking; nevertheless, authors report variable percentages of residual knee pain and dissatisfaction in re-treated patients. Therefore, it would be desirable to prevent the maltracking condition at the time of primary arthroplasty, using proper surgical precautions.
Similar content being viewed by others
Avoid common mistakes on your manuscript.
Introduction
Total knee arthroplasty (TKA) has become the standard treatment for various disabling disorders of the knee, especially end-stage osteoarthritis, and has proven long-term success. Surgical technique and prosthetic design have evolved to produce consistent and excellent results. Nevertheless, dissatisfaction rates among patients vary from 11 to 25% [1,2,3,4,5,6].
Patellofemoral joint disorders are the most frequent causes of painful knee and early failure after TKA [7, 8]: patella maltracking is one the most common conditions with an incidence that range from 1 to 20% and is generally a consequence of intraoperative technical errors [9, 10].
Patella maltracking is defined as a displacement of the patella center to a pathological position and features conditions like excessive patellar tilt, subluxation or complete dislocation [11].
Patella maltracking after TKA can lead to anterior knee pain (especially during activities such as stair climbing or chair rising) [12], increased component wear (with higher risk of component loosening), patellar fracture and instability [13].
In TKA, the key for obtaining an optimal patellar tracking should focus on achieving the correct patellar position, maintaining a stable tibio-femoral joint at the same time [11, 14].
Patella maltracking can generally be attributed to patient-related factors, implant design or surgical technique [15]. Demonstrated patient-related factors are preoperative valgus alignment [12], weakness of the quadriceps muscle (particularly the vastus medialis oblique) [1], patellofemoral dysplasia and/or previous patellar subluxation episodes [15], a lateral patellar shift > 3 mm in axial radiographs [16, 17]. The effect of implant design on patellofemoral stability is well recognized: femoral components featuring symmetrical and shallow trochlear groove have been shown to create abnormal patellar kinematics and increase the risk of patella maltracking [15, 18].
Errors in surgical procedures are the most frequent causes of patella maltracking: residual valgus limb malalignment, patella alta, excessive internal rotation of the femoral and/or tibial component, valgus alignment of the femoral component, asymmetrical patellar resection, lateral positioning or excessive thickness of the patellar button, incorrect soft-tissue balancing and missing or insufficient lateral release if needed have all been shown to have a negative effect on patella tracking [2, 11, 13, 15, 19, 20].
Over the years, many authors have proposed technical solutions to prevent patella maltracking in TKA, as reported by numerous in vitro and in vivo papers. Main measures concern the adequate positioning of the prosthetic components [2, 21,22,23,24,25,26,27,28,29,30], prefer prosthesis with anatomical “patella-friendly” femoral component design [31,32,33,34], a staged lateral retinaculum release carried out step by step [35,36,37,38,39,40] or a lateral patellar osteotomy as an alternative to decompress the lateral ligamentous structures [41, 42], access the knee joint through a lateral parapatellar or subvastus approach, particularly in the valgus knee [43,44,45,46,47].
Even if there is agreement between authors regarding the preoperative and intra-operative management of patella maltracking in TKA, less clear are the postoperative conducts.
The literature provides many case-reports and case-series studies regarding this topic, describing surgical procedures as lateral retinaculum releases, medial soft-tissue reconstructions, proximal and/or distal realignment techniques of the extensor apparatus, partial or complete revision of prosthetic components. Nevertheless, the literature lacks a systematic collection of the aforementioned works, mostly concerning complications and adequate indications of these techniques in specific cases. The purpose of this systematic review is to summarize and compare indications, complications, clinical, functional, and radiological results of surgical techniques used to treat the patella maltracking after TKA.
Material and methods
A systematic review of the literature was performed with a primary search on Medline through PubMed used the following key-words: ((total knee replacement OR total knee arthroplasty) AND (patella maltracking OR patella instability OR patella malalignment OR patella dislocation OR patella displacement OR patella shift OR patella tilt OR patella subluxation OR patella luxation)).
The inclusion criteria were: studies providing clinical, functional and radiological results and complications concerning the treatment of patella maltracking after TKA, specifically in postoperative management; retrospective or prospective clinical studies including randomized controlled trials, nonrandomized trials, cohort studies, case–control, case-reports and case-series studies with a minimum follow-up of 1 year; papers in English without any restriction on publication date. The exclusion criteria were: review articles; in vitro or experimental biomechanical or cadaveric studies; papers not in English; studies concerning preoperative and intra-intraoperative precautions to avoid patella maltracking in total knee arthroplasty; studies concerning the management of patella maltracking in unicompartmental knee arthroplasty (both femoro-tibial and patello-femoral arthroplasty).
One author applied the previously determined criteria to select potentially relevant papers. Articles were initially identified based on title and abstract: full-text versions of relevant trials were then obtained and evaluated. References of the identified articles were checked not to miss any further relevant articles. The PRISMA 2009 flow chart and checklist were considered to edit the review.
The Level of Evidence (LOE) of the studies was assigned based on the 2011 Oxford Centre for Evidence-based Medicine Levels of Evidence.
The following data, when available, were extracted from the articles: Level of Evidence, number of patients, number of treated knees, mean age of patients, preoperative diagnosis (particularly if the postoperative treatment of patella maltracking regarded primary or revision TKA), main treatment, mean follow-up, the success rate in clinical, functional, and radiological tracking correction, complications occurred.
Results
A total of 21 articles were finally included in the systematic review. The PRISMA 2009 diagram illustrates the studies that have been identified, included, and excluded (Fig. 1). Table 1 describes data extracted from the included papers, and Table 2 summarizes the main surgical procedures used by authors to treat the patella maltracking after TKA.
Most of the papers were rated as level IV according to the 2011 Oxford Center for Evidence-based Medicine Levels of Evidences; just two studies were rated as level V being case reports. All selected studies provide clinical, functional, and radiological results and complications concerning the management of patella maltracking after TKA, specifically in postoperative treatments.
Discussion
Because nonsurgical treatments such as bracing and physical therapy after primary or revision TKA are not very effective to solve patella maltracking, surgical intervention is usually indicated [67].
First of all, it is crucial to identify the cause of the maltracking condition, to select the appropriate surgical procedure [60, 62, 65].
In the absence of components malpositioning, soft-tissue reconstructions of the extensor mechanism should be considered as a first measure to manage patella maltracking. Sometimes, a lateral retinaculum release could be enough to address patella maltracking [9, 18, 52], preserving the superior lateral geniculate vessels and performed step by step starting from the release of the lateral patellofemoral ligament and proceeding distally as long as needed [35, 39]. Bocell et al. [49], Johnson et al. [50] reported excellent results in patella tracking restoration performing an arthroscopic lateral release with the resolution of patellar symptoms. Nevertheless, performing an arthroscopy procedure after TKA is a technically challenging procedure and further studies are needed to define indications and expected results [49, 50]. A lateral retinaculum release is rarely performed alone and often is used together with other soft-tissue procedures as the advancement of the vastus medialis oblique or a balanced medial plication [18, 52, 63]. Furthermore, Chin et al. [52] reported a V–Y quadricepsplasty in severe cases of extensor mechanism tightness and Shen et al. [64] proposed a partial lateral patella facetectomy in addition to the lateral retinaculum release.
Whiteside et al. [53] suggest that simple lateral releases, medial plications and extra-articular vastus medialis advancements often are insufficient to correct mechanical patellar abnormalities and to prevent progressive subluxation; however, these techniques could be used as a first line of treatment or as a support to other surgical procedures.
During the 1990s, more attention was directed toward the medial patellofemoral ligament (MPFL) as one of the important medial stabilizers of the patella. Several biomechanical studies have demonstrated that the MPFL is the primary patella medial restraint, and a number of clinical studies have shown that patellar dislocation is often associated with injuries of the MPFL [60]. In TKA procedures, the medial structures can be damaged, due to the use of a medial parapatellar approach, patellar eversion and an inadequate closure, leading to patellar displacement [62]. Asada et al. [54], Goto et al. [61], Lamotte et al. [62], Van Gennip et al. [60] have demonstrated that the patellofemoral realignment procedure with MPFL reconstruction is an effective treatment for patellar symptomatic subluxation or dislocation after TKA in terms of achieving excellent results in the restore of clinical and radiographic patella tracking and improvement in functional scores, with minimum or null complications reported. MPFL reconstruction was carried out by authors using a quadriceps tendon split [60] or a tendon graft as semitendinosus [54, 60, 61], gracilis [62] or tibialis posterior [60]. Generally, the new MPFL is tightened from the medial side of the patella to a point between the adductor tubercle and the medial epicondyle: this technique guarantees the most anatomical and isometric reconstruction of the MPFL [60]. The reconstruction can be carried forward also through an extra-articular procedure as described by Asada et al. [54]: anchoring the graft to the distal site of the adductor tubercle and fixing the opposite end onto the proximal one-third of the patellar surface in an interlacing fashion, this technique allows to not open the joint capsule, with advantages in terms of reduction of surgical time and overall complications.
Patellofemoral realignment procedure with MPFL reconstruction is an effective treatment in patella maltracking exclusively in patients without malrotation of the prosthetic components. MPFL reconstruction should be performed only after a CT-scan, excluding abnormal internal rotation of the femoral component and/or pathological TT-TG distance, that could make the MPFL reconstruction alone ineffective for the restore of correct patellar tracking [54, 60,61,62].
Extensor mechanism realignment procedures (proximal, distal or combined) have been proposed by several authors in the last decades. Merkow et al. [9] and Grace et al. [48] have managed patients with patella maltracking after TKA performing a proximal realignment procedure as illustrated by Insall, achieving optimal results. This technique consist in an exposure of the quadriceps mechanism through a midline skin incision and two deep capsular incisions, one medial and the other lateral. Realignment is accomplished by advancing the medial flap containing the vastus medialis, laterally and distally in line with the fibers of the oblique portion of the vastus medialis over the anterior surface of the patella. After suturing the edge of the advanced medial flap in place near the lateral margin of the patella, the suture is completed along the front of the patella and the lateral release is performed. This realignment technique corrects patellar tilt and decreases the functional quadriceps angle, changing the direction of pull of the quadriceps muscle [9]. Nevertheless, in case of increased Q-angle as main etiologic cause of the patella maltracking, distal realignment procedures are preferable, even as additional procedure if the proximal realignment appears insufficient to restore good patellar tracking [51, 53].
Several distal realignment techniques were described to manage the patella maltracking. Procedures as the Hauser [48], Emslie-Trillat [18, 51, 53, 57] and Fulkerson [56] consist in a medial and variable distal displacement of the tibial tubercle, secured with screws or wires to the tibial cortex, while Roux-Goldthwait techniques [53] consist in a medial transferring of the lateral or medial ½ of the patellar tendon, sutured directly to the capsular edge. Notable works developed by Grace et al.[48], Kirk et al. [51], Campbell et al. [18], Whiteside et al. [53], Price et al. [56], Nakajima et al. [57], Van Gennip et al. [60] proposed these distal realignment procedures to treat patella maltracking after TKA with optimal results. Distal realignment procedures featuring a tibial tubercle transfer should be selected with caution in patients with osteoporotic tibial metaphysis or poor tibial bone stock as in revision TKAs. In fact, in these cases, there is a greater risk of complications as nonunion or osteonecrosis of the tibial tubercle fragment with loss of staple fixation, patellar tendon rupture, variable loss of flexion arch, and hematomas that could lead to a wound or deep infection [9, 48, 51, 53]. Furthermore, the fixation of the tubercle fragment in revision TKAs could be hard considering the stemmed prosthetic implant [51, 56]. Distal realignment techniques that do not use tibial tubercle transfer as the Roux-Goldthwait appear to have lower complication rates: Whiteside et al. [53] reported no significant patellar complications occurred in patients who underwent these procedures, even if may appear insufficient to restore an adequate patella tracking in case of severe patellar subluxation or persistent dislocation.
Another limitation of tibial tubercle transfer techniques is an inability to perfectly normalize the patellar tilt, which, however, not significantly affect the clinical outcome [57].
Patella maltracking after TKA is often due to malrotated prosthetic components. Incavo et al. [55], Lakstein et al. [58], Pietsch et al. [59], Warschawski et al. [65] and other authors largely demonstrated that patients with painful TKAs resulting from components malrotation can achieve symptomatic improvement with revision surgery, preferably within 2 years from the primary procedure. Authors suggest also replacing the patella even if it has not been performed in the primary arthroplasty procedure, especially if its thickness is adequate and better following procedural helpful measures such as the medialization of the patellar button [18, 55, 59].
Only a CT scan should be considered an accurate method to diagnose and quantify the degree of rotational malalignment of the prosthetic components [58, 59, 65]. Despite the consensus between authors to consider the tibial component as internal rotated if its antero-posterior axis is directed medial to the medial third of the tibial tubercle [55], agreement regarding the definition of the femoral prosthetic component as internal rotated remains unclear. The cut-off angle was defined in relation to the posterior condylar angle as 4° according to Pietsch et al. [59] and 3° to Lakstein et al. [58], while Incavo et al. [55] proposed a femoral component as internal rotated above 5° from the epicondylar axis.
Authors suggest that complete revision leads to better clinical results compared to a partial revision, even in cases of isolated femoral internal malrotation [55, 59, 65]. In fact, if the femoral component is internally rotated, there are generally consequences regarding altered flexion spaces with a tight internal compartment and a mediolateral soft-tissue imbalance, difficult to restore only with a singular component revision. Also, the relatively good results after revision surgery in these procedures often require the use of a constrained condylar prostheses: this cannot be used if the original tibial component is left in place [55].
Considering the malpositioning of prosthetic components, Saito et al. [66] described a successful treatment of an habitual patellar dislocation after a TKA with the femoral component implanted at an extremely valgus position using a medial closing-wedge distal femoral osteotomy, reporting optimal patella tracking correction and patient’s clinical satisfaction. Nevertheless, further studies are needed to define osteotomy procedures as efficient and reproducible techniques to manage patella maltracking in case of axial malpositioning of the prosthetic components.
A meta-analysis could not be performed from this systematic review because of the insufficient statistical power correlated to the low number of cases in some of the included studies and the heterogeneity related to the different clinical and functional score system used by authors to describe their results. Furthermore, five of the included studies have not declared any specific score system and feature only a qualitative descriptions of the results. It could be also difficult to fully compare the results of patella maltracking correction without a cases homogenization about knee prosthetic model and alignment method adopted.
A last limitation of this review concerns the use in many included works of combined procedures to manage the patella maltracking; thus, it could be difficult in certain articles to interpret the relative contribution of single techniques in the final correction result obtained.
Conclusion
This review of the literature describes in a systematic collection the main techniques used by authors to approach patella maltracking after total knee arthroplasty, representing a frequent and hard to manage problem for orthopedic surgeons. Treatments described by authors range from simple soft-tissue procedures to complete prosthetic components revision. The indication of a specific technique depends on several factors, first of all the eventual malpositioning of prosthetic components. Furthermore, paying attention to the patient’s clinical characteristics as osteoporosis, vascular suffering conditions or having an already revisioned knee could be helpful in the choice of proper procedures.
Although these established operative techniques are able to correct an abnormal patellar tracking, as proved by radiograms and clinical evidences of right patellofemoral relationship in the flexo-extension arch, authors report constantly variable percentages of residual knee pain and dissatisfaction in re-treated patients.
Since it is largely demonstrated that patella maltracking is generally a consequence of intra-operative technical errors, it is desirable to prevent maltracking conditions at the time of primary arthroplasty using proper surgical precautions, especially for the emotional and financial costs derived from a revision procedure.
Availability of data and materials
Not applicable.
References
Petersen W, Rembitzki IV, Brüggemann G-P et al (2014) Anterior knee pain after total knee arthroplasty: a narrative review. Int Orthop 38:319–328. https://doi.org/10.1007/s00264-013-2081-4
Berger RA, Crossett LS, Jacobs JJ, Rubash HE (1998) Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop. https://doi.org/10.1097/00003086-199811000-00021
Heck DA, Robinson RL, Partridge CM et al (1998) Patient outcomes after knee replacement. Clin Orthop. https://doi.org/10.1097/00003086-199811000-00015
Noble PC, Gordon MJ, Weiss JM et al (2005) Does total knee replacement restore normal knee function? Clin Orthop. https://doi.org/10.1097/01.blo.0000150130.03519.fb
Anderson JG, Wixson RL, Tsai D et al (1996) Functional outcome and patient satisfaction in total knee patients over the age of 75. J Arthroplasty 11:831–840. https://doi.org/10.1016/s0883-5403(96)80183-5
Kurtz SM, Ong KL, Lau E et al (2011) International survey of primary and revision total knee replacement. Int Orthop 35:1783–1789. https://doi.org/10.1007/s00264-011-1235-5
Aglietti P, Buzzi R, Gaudenzi A (1988) Patellofemoral functional results and complications with the posterior stabilized total condylar Knee prosthesis. J Arthroplasty 3:17–25. https://doi.org/10.1016/s0883-5403(88)80049-4
Lachiewicz PF, Soileau ES (2006) Patella maltracking in posterior-stabilized total knee arthroplasty. Clin Orthop 452:155–158. https://doi.org/10.1097/01.blo.0000238803.97713.7d
Merkow RL, Soudry M, Insall JN (1985) Patellar dislocation following total Knee replacement. J Bone Joint Surg Am 67:1321–1327
Assiotis A, To K, Morgan-Jones R et al (2019) Patellar complications following total knee arthroplasty: a review of the current literature. Eur J Orthop Surg Traumatol Orthop Traumatol 29:1605–1615. https://doi.org/10.1007/s00590-019-02499-z
Donell S (2018) Patellar tracking in primary total knee arthroplasty. EFORT Open Rev 3:106–113. https://doi.org/10.1302/2058-5241.3.170036
Motsis EK, Paschos N, Pakos EE, Georgoulis AD (2009) Review article: patellar instability after total knee arthroplasty. J Orthop Surg Hong Kong 17:351–357. https://doi.org/10.1177/230949900901700322
Anglin C, Ho KCT, Briard J-L et al (2008) In vivo patellar kinematics during total knee arthroplasty. Comput Aided Surg Off J Int Soc Comput Aided Surg 13:377–391. https://doi.org/10.3109/10929080802594563
Keshmiri A, Maderbacher G, Baier C et al (2016) Significant influence of rotational limb alignment parameters on patellar kinematics: an in vitro study. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 24:2407–2414. https://doi.org/10.1007/s00167-014-3434-2
Gasparini G, Familiari F, Ranuccio F (2013) Patellar malalignment treatment in total knee arthroplasty. Joints 1:10–17
Rajkumar N, Soundarrajan D, Dhanasekararaja P, Rajasekaran S (2019) Preoperative radiological parameters predicting the need for lateral retinacular release in total knee arthroplasty. J Arthroplasty 34:2925–2930. https://doi.org/10.1016/j.arth.2019.07.033
Chia S-L, Merican AM, Devadasan B et al (2009) Radiographic features predictive of patellar maltracking during total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 17:1217–1224. https://doi.org/10.1007/s00167-009-0832-y
Campbell DG, Mintz AD, Stevenson TM (1995) Early patellofemoral revision following total knee arthroplasty. J Arthroplasty 10:287–291. https://doi.org/10.1016/s0883-5403(05)80176-7
Kawano T, Miura H, Nagamine R et al (2002) Factors affecting patellar tracking after total knee arthroplasty. J Arthroplasty 17:942–947. https://doi.org/10.1054/arth.2002.34826
Matz J, Lanting BA, Howard JL (2019) Understanding the patellofemoral joint in total knee arthroplasty. Can J Surg J Can Chir 62:57–65. https://doi.org/10.1503/cjs.001617
Arima J, Whiteside LA, McCarthy DS, White SE (1995) Femoral rotational alignment, based on the anteroposterior axis, in total knee arthroplasty in a valgus knee. A technical note. J Bone Joint Surg Am 77:1331–1334. https://doi.org/10.2106/00004623-199509000-00006
Whiteside LA, Arima J (1995) The anteroposterior axis for femoral rotational alignment in valgus total knee arthroplasty. Clin Orthop 321:168–172
Terashima T, Onodera T, Sawaguchi N et al (2015) External rotation of the femoral component decreases patellofemoral contact stress in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 23:3266–3272. https://doi.org/10.1007/s00167-014-3103-5
Keshmiri A, Maderbacher G, Baier C et al (2015) The influence of component alignment on patellar kinematics in total knee arthroplasty. Acta Orthop 86:444–450. https://doi.org/10.3109/17453674.2015.1005907
Ko DO, Lee S, Kim JH et al (2021) The Influence of femoral internal rotation on patellar tracking in total knee arthroplasty using gap technique. Clin Orthop Surg 13:352–357. https://doi.org/10.4055/cios20168
Slevin O, Schmid FA, Schiapparelli F-F et al (2017) Coronal femoral TKA position significantly influences in vivo patellar loading in unresurfaced patellae after primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 25:3605–3610. https://doi.org/10.1007/s00167-017-4627-2
Lewonowski K, Dorr LD, McPherson EJ et al (1997) Medialization of the patella in total knee arthroplasty. J Arthroplasty 12:161–167. https://doi.org/10.1016/s0883-5403(97)90062-0
Anglin C, Brimacombe JM, Wilson DR et al (2010) Biomechanical consequences of patellar component medialization in total knee arthroplasty. J Arthroplasty 25:793–802. https://doi.org/10.1016/j.arth.2009.04.023
Lee RH, Jeong HW, Lee JK, Choi CH (2017) Should the position of the patellar component replicate the vertical median ridge of the native patella? Knee 24:82–90. https://doi.org/10.1016/j.knee.2016.09.014
Hofmann AA, Tkach TK, Evanich CJ et al (1997) Patellar component medialization in total knee arthroplasty. J Arthroplasty 12:155–160. https://doi.org/10.1016/s0883-5403(97)90061-9
Petersilge WJ, Oishi CS, Kaufman KR et al (1994) The effect of trochlear design on patellofemoral shear and compressive forces in total knee arthroplasty. Clin Orthop 309:124–130
Yoshii I, Whiteside LA, Anouchi YS (1992) The effect of patellar button placement and femoral component design on patellar tracking in total knee arthroplasty. Clin Orthop 275:211–219
Theiss SM, Kitziger KJ, Lotke PS, Lotke PA (1996) Component design affecting patellofemoral complications after total knee arthroplasty. Clin Orthop. https://doi.org/10.1097/00003086-199605000-00021
Matz J, Howard JL, Sisko ZW et al (2017) Differences in trochlear surface damage and wear between three different total knee arthroplasty designs. J Arthroplasty 32:3763–3770. https://doi.org/10.1016/j.arth.2017.06.037
Strachan RK, Merican AM, Devadasan B et al (2009) A technique of staged lateral release to correct patellar tracking in total knee arthroplasty. J Arthroplasty 24:735–742. https://doi.org/10.1016/j.arth.2008.02.005
Ritter MA, Herbst SA, Keating EM et al (1996) Patellofemoral complications following total knee arthroplasty. Effect of a lateral release and sacrifice of the superior lateral geniculate artery. J Arthroplasty 11:368–372. https://doi.org/10.1016/s0883-5403(96)80024-6
Archibeck MJ, Camarata D, Trauger J et al (2003) Indications for lateral retinacular release in total knee replacement. Clin Orthop. https://doi.org/10.1097/01.blo.0000079260.91782.96
Sodha S, Kim J, McGuire KJ et al (2004) Lateral retinacular release as a function of femoral component rotation in total knee arthroplasty. J Arthroplasty 19:459–463. https://doi.org/10.1016/j.arth.2003.12.072
Subramanyam P, Sundaram PS, Rao N (2012) Scintigraphic assessment of patellar vascularity in total knee replacement surgeries following lateral release. Avicenna J Med 2:54–59. https://doi.org/10.4103/2231-0770.102277
Weber AB, Worland RL, Jessup DE et al (2003) The consequences of lateral release in total knee replacement: a review of over 1000 knees with follow up between 5 and 11 years. Knee 10:187–191. https://doi.org/10.1016/s0968-0160(02)00059-5
Lakstein D, Naser M, Adar E et al (2014) Partial lateral patellar facetectomy as an alternative to lateral release in Total Knee Arthroplasty (TKA). J Arthroplasty 29:2146–2149. https://doi.org/10.1016/j.arth.2014.06.013
Wachtl SW, Jakob RP (2000) Patella osteotomy for lateral retinaculum decompression in total knee arthroplasty. Acta Orthop Scand 71:522–524. https://doi.org/10.1080/000164700317381252
Satish BRJ, Ganesan JC, Chandran P et al (2013) Efficacy and mid term results of lateral parapatellar approach without tibial tubercle osteotomy for primary total knee arthroplasty in fixed valgus knees. J Arthroplasty 28:1751–1756. https://doi.org/10.1016/j.arth.2013.04.037
Engh GA, Parks NL, Ammeen DJ (1996) Influence of surgical approach on lateral retinacular releases in total knee arthroplasty. Clin Orthop. https://doi.org/10.1097/00003086-199610000-00008
Bindelglass DF, Vince KG (1996) Patellar tilt and subluxation following subvastus and parapatellar approach in total knee arthroplasty. Implic Surg Tech J Arthroplasty 11:507–511. https://doi.org/10.1016/s0883-5403(96)80101-x
Kong C-G, Cho H-M, Suhl K-H et al (2012) Patellar tracking after total knee arthroplasty performed without lateral release. Knee 19:692–695. https://doi.org/10.1016/j.knee.2011.09.007
Matsueda M, Gustilo RB (2000) Subvastus and medial parapatellar approaches in total knee arthroplasty. Clin Orthop. https://doi.org/10.1097/00003086-200002000-00020
Grace JN, Rand JA (1988) Patellar instability after total knee arthroplasty. Clin Orthop 237:184–189
Bocell JR, Thorpe CD, Tullos HS (1991) Arthroscopic treatment of symptomatic total knee arthroplasty. Clin Orthop 271:125–134
Johnson DR, Friedman RJ, McGinty JB et al (1990) The role of arthroscopy in the problem total knee replacement. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 6:30–32. https://doi.org/10.1016/0749-8063(90)90093-s
Kirk P, Rorabeck CH, Bourne RB et al (1992) Management of recurrent dislocation of the patella following total knee arthroplasty. J Arthroplasty 7:229–233. https://doi.org/10.1016/0883-5403(92)90041-n
Chin KR, Bae DS, Lonner JH, Scott RD (2004) Revision surgery for patellar dislocation after primary total knee arthroplasty. J Arthroplasty 19:956–961. https://doi.org/10.1016/j.arth.2004.03.018
Whiteside LA (1997) Distal realignment of the patellar tendon to correct abnormal patellar tracking. Clin Orthop 344:284–289
Asada S, Akagi M, Mori S, Hamanishi C (2008) Medial patellofemoral ligament reconstruction for recurrent patellar dislocation after total knee arthroplasty. J Orthop Sci Off J Jpn Orthop Assoc 13:255–258. https://doi.org/10.1007/s00776-007-1219-x
Incavo SJ, Wild JJ, Coughlin KM, Beynnon BD (2007) Early revision for component malrotation in total knee arthroplasty. Clin Orthop 458:131–136. https://doi.org/10.1097/BLO.0b013e3180332d97
Price M, Malkani AL, Baker D (2009) Fulkerson procedure for chronic patella component dislocation after total knee arthroplasty. J Arthroplasty 24:914–917. https://doi.org/10.1016/j.arth.2008.05.007
Nakajima A, Watanabe H, Rokkaku T et al (2010) The Elmslie-Trillat procedure for recurrent patellar subluxation after total knee arthroplasty. J Arthroplasty 25:1170.e1–5. https://doi.org/10.1016/j.arth.2009.09.008
Lakstein D, Zarrabian M, Kosashvili Y et al (2010) Revision total knee arthroplasty for component malrotation is highly beneficial: a case control study. J Arthroplasty 25:1047–1052. https://doi.org/10.1016/j.arth.2009.07.004
Pietsch M, Hofmann S (2012) Early revision for isolated internal malrotation of the femoral component in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 20:1057–1063. https://doi.org/10.1007/s00167-011-1637-3
van Gennip S, Schimmel JJP, van Hellemondt GG et al (2014) Medial patellofemoral ligament reconstruction for patellar maltracking following total knee arthroplasty is effective. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 22:2569–2573. https://doi.org/10.1007/s00167-012-2269-y
Goto T, Hamada D, Iwame T et al (2014) Medial patellofemoral ligament reconstruction for patellar dislocation due to rupture of the medial structures after total knee arthroplasty: a case report and review of the literature. J Med Investig JMI 61:409–412. https://doi.org/10.2152/jmi.61.409
Lamotte A, Neri T, Kawaye A et al (2016) Medial patellofemoral ligament reconstruction for patellar instability following total knee arthroplasty: a review of 6 cases. Orthop Traumatol Surg Res OTSR 102:607–610. https://doi.org/10.1016/j.otsr.2016.03.018
Matar HE, Illanes FL, Gollish JD (2020) Extensive proximal extensor mechanism realignment for chronic patella dislocations in revision knee arthroplasty: surgical technique. Knee 27:1821–1832. https://doi.org/10.1016/j.knee.2020.09.018
Shen X-Y, Zuo J-L, Gao J-P et al (2020) New treatment of patellar instability after total knee arthroplasty: a case report and review of literature. World J Clin Cases 8:5487–5493. https://doi.org/10.12998/wjcc.v8.i21.5487
Warschawski Y, Garceau S, Frenkel Rutenberg T et al (2020) Revision total knee arthroplasty for patellar dislocation in patients with malrotated TKA components. Arch Orthop Trauma Surg 140:777–783. https://doi.org/10.1007/s00402-020-03468-6
Saito H, Saito K, Shimada Y et al (2020) Successful treatment of a habitual patellar dislocation after a total knee arthroplasty with a closing-wedge distal femoral varus osteotomy and medial patello-femoral ligament reconstruction. J Exp Orthop 7:63. https://doi.org/10.1186/s40634-020-00281-3
Mäenpää H, Lehto MU (1997) Patellar dislocation. The long-term results of nonoperative management in 100 patients. Am J Sports Med 25:213–217. https://doi.org/10.1177/036354659702500213
Funding
Open access funding provided by Alma Mater Studiorum - Università di Bologna within the CRUI-CARE Agreement. No funding was received by any of the authors.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
Not applicable.
Consent to participate
Not applicable.
Consent to publish
Not applicable.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Ferri, R., Digennaro, V., Panciera, A. et al. Management of patella maltracking after total knee arthroplasty: a systematic review. Musculoskelet Surg 107, 143–157 (2023). https://doi.org/10.1007/s12306-022-00764-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12306-022-00764-9