The Effect of Medial Release of the Distal Patellar Tendon Insertion on Lateral Patella Translation and Residual Insertion Strength: A Cadaveric Study

• Published in: The Journal of arthroplasty Vol. 29; no. 3; pp. 525 - 529
• Main Authors: Dervin, Geoffrey F., MD, MSc, FRCS(C), Whitehead, Timothy, MD, FACS, Poitras, Phil, MASc, Parai, Milton, MD, FRCSC, Louati, Hakim, B Eng
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2014
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Arthroplasty, Replacement, Knee - adverse effects; Biomechanical Phenomena; Cadaver; Female; Humans; Male; Middle Aged; Muscle Strength; Orthopedics; Patella - physiopathology; Patella - surgery; patella tendon; Patellar Ligament - anatomy & histology; Patellar Ligament - injuries; Patellar Ligament - physiopathology; Patellar Ligament - surgery; Random Allocation; Rupture; Tendon Injuries - etiology; Tendon Injuries - physiopathology; tibial insertion; total knee arthroplasty; total knee arthroplasty; tibial insertion; cadaver; patella tendon
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2013.07.044

Abstract Patellar tendon avulsion is a risk with difficult exposure in a stiff knee, patella baja or previous tibial osteotomy. We sought to define a safe amount of release of the patellar tendon insertion for such cases. Eleven pairs of fresh frozen cadaveric lower limb specimens were acquired and randomized to either intact or partial release of the distal tibial insertion. Partial release of the tibial insertion of the tendon increased lateral exposure a mean 29% ± 15% ( P = 0.002) while reducing ultimate strength to a mean of 80% that of the intact contralateral tendon. Measured patella release increased lateral patella translation and can be performed without risk of catastrophic rupture with basic activities of daily living following TKA.