Association of increased knee flexion and patella clunk syndrome after mini-subvastus total knee arthroplasty |
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Authors: | Schroer William C Diesfeld Paul J Reedy Mary E LeMarr Angela |
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Affiliation: | St. Louis Joint Replacement Institute, Premier Care Orthopedics, Signature Health Services, St. Louis, Missouri 63044, USA. |
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Abstract: | This study reviewed 747 consecutive posterior stabilized total knee arthroplasty (TKA) to explain the increased incidence of patella clunk syndrome that occurred when the surgeon switched from a medial parapatellar arthrotomy to a mini-subvastus (MIS) TKA technique. The incidence of patella clunk syndrome increased with increased postoperative knee flexion. Six weeks after surgery, knees that developed patella clunk had a mean flexion of 124 degrees vs 117 degrees for knees that did not develop this syndrome (P = .016). As the MIS approach resulted in increased knee flexion, this approach was indirectly associated with the increased incidence of patella clunk. Knee flexion at 6 weeks postoperatively was 117 degrees for the MIS knees vs 108 degrees for traditional medial parapatellar arthrotomy knees (P < .001). The effect of increased knee flexion achieved with the MIS approach, which resulted in an increase in patella clunk, was mitigated by using a new posterior stabilized femoral component designed to minimize soft tissue entrapment. |
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Keywords: | patella clunk knee flexion mini-subvastus minimally invasive surgery knee arthroplasty |
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