Abstract
In total knee arthroplasty with patellar resurfacing, surgeons are often faced with a choice of where to position the patellar button. Patellar button positioning has been studied in relation to patellar tracking and risk of subluxation. Consequently, medial placement has been recommended. However, postoperative gait and risk of periprosthetic complications have not been thoroughly addressed in relation to patellar button positioning.
Highlights
The annual demand for total knee arthroplasty (TKA) in the United States is projected to reach 3.48 million procedures by 2030 [1]
Cadaveric patellar characteristics: Kinematic analysis performed on post-total knee replacement (TKA) cadaveric knee specimens with the button in the central position resulted in plots of patellar extension and tilt versus knee flexion
The distal position resulted in lowest peak forces for the rectus femoris, vastus intermedialis, and vastus medialis
Summary
The annual demand for total knee arthroplasty (TKA) in the United States is projected to reach 3.48 million procedures by 2030 [1]. The rate of patellofemoral complications for primary TKA is generally under 10% for both resurfaced [4,5] and non-resurfaced knees [4,6,7], but some authors attribute an increase in complications to resurfacing. Such complications include pain [8], maltracking, instability, excessive thickness [6], button loosening [5], periprosthetic patellar fractures [9], and polyethylene wear [10]. Postoperative gait and risk of periprosthetic complications have not been thoroughly addressed in relation to patellar button positioning
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