Pathomechanics of the femoropatellar joint following total knee arthroplasty

Persistent discomfort in the femoropatellar joint is still one of the most disappointing aspects following total knee arthroplasty (TKA). Especially, TKA without patellofemoral replacement has a significant incidence of patellofemoral problems with a frequency between 5% and 45%. Pathomechanical fac...

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Bibliographic Details
Published inClinical orthopaedics and related research no. 224; p. 251
Main Authors Hofmann, G O, Hagena, F W
Format Journal Article
LanguageEnglish
Published United States 01.11.1987
Subjects
Biomechanical Phenomena
Femur - physiopathology
Humans
Knee Joint - diagnostic imaging
Knee Joint - physiopathology
Knee Prosthesis
Pain
Patella - physiopathology
Postoperative Complications - physiopathology
Radiography
Radionuclide Imaging
Technetium Tc 99m Medronate
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Summary:Persistent discomfort in the femoropatellar joint is still one of the most disappointing aspects following total knee arthroplasty (TKA). Especially, TKA without patellofemoral replacement has a significant incidence of patellofemoral problems with a frequency between 5% and 45%. Pathomechanical factors in the development of retropatellar problems are loss of patellar thickness and retropatellar erosions. In 157 TKAs using Gschwend, Scheier, Bähler (GSB) joints without patellar resurfacing, pathomechanically postoperative vertical patellar malposition appeared to be the main cause of dysfunction. In many cases, the implantation technique leads to an artificial form of patella alta. This altered knee anatomy results in pathologic biomechanics, thus leading to reduced function. The combination of altered anatomy and reduced function leads to extensive patellar destruction and ultimately to intractable retropatellar pain.
ISSN:0009-921X
1528-1132
DOI:10.1097/00003086-198711000-00034