Freehand resection of the patella in total knee arthroplasty referencing the attachments of the quadriceps tendon and patellar tendon |
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| Affiliation: | 1. Joint Implant Surgeons, Inc., Columbus, Ohio USA;2. Divisions of Orthopaedic Surgery, The Ohio State University, Columbus, Ohio USA;3. Division of Biomedical Engineering, The Ohio State University, Columbus, Ohio USA;4. Sections of Orthopedics, The Ohio Orthopaedic Institute, Grant Medical Center, Columbus, Ohio USA;5. Joint Implant Surgery, The Ohio Orthopaedic Institute, Grant Medical Center, Columbus, Ohio USA;1. Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals, School of Medicine, University of Leeds, Leeds, United Kingdom;2. NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, United Kingdom;1. Harvard Radiation Oncology Program, Boston, Massachusetts;2. Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts;3. Department of Diagnostic Radiology, Massachusetts General Hospital, Boston, Massachusetts;6. Department of Orthopedic Oncology, Massachusetts General Hospital, Boston, Massachusetts;4. Centre of Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia |
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| Abstract: | A freehand technique of patellar resurfacing using anatomic references was prospectively evaluated. This technique utilizes an osteotomy beginning at the inferior pole of the patella just posterior to the insertion of the patellar tendon and is carried proximally posterior to the insertion of the quadriceps tendon. Evaluation of 55 total knee arthroplasties in 41 patients showed an average restored patellar thickness within 0.1 mm. The overall patellar thickness was restored to within 1 mm of its preoperative thickness in 50 (91%) of 55 knees. Patellar tilt was equal to or less than 4° in 42 (89%) of 47 arthroplasties evaluated radiographically. The patellar thickness averaged 17.9 mm, well above the critical value of 15 mm reported in the literature. |
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