J Korean Orthop Assoc.  2010 Apr;45(2):133-138. 10.4055/jkoa.2010.45.2.133.

Clinical Value of "The Single Stitch Method" in Intraoperative Assessment of Patellar Tracking in Total Knee Arthroplasty

• Youm YS
• Cho SD
• Jung CY
• Park HC

• KMID: 2185581
• DOI: http://doi.org/10.4055/jkoa.2010.45.2.133

Abstract

PURPOSE
We evaluated the lateral release rate and the clinical results according to the intraoperative assessment of patellar tracking in total knee arthroplasty (TKA).
MATERIALS AND METHODS
We analyzed 365 primary total knee arthroplasties in 278 patients. The knees showing good patellar tracking without tourniquet deflation were classified into group 1, those showing improved patellar tracking after tourniquet deflation were classified into group 2, those showing improved patellar tracking after the single stitch method were classified into group 3 and those showing persistent patellar maltracking, that resulted in lateral retinacular release, were classified into group 4. The postoperative patellar tilting angle was measured and the clinical results were evaluated for all the groups.
RESULTS
We classified 176, 127, 57 and 5 knees into groups 1, 2, 3 and 4 respectively. Only 5 knees (1.4%) showed poor patellar tracking with the single stitch method after tourniquet deflation and this resulted in lateral retinacular release. The postoperative mean patellar tilting angle was 4.1degrees, 3.4degrees, 5.1degrees and 4.3degrees in each group, respectively, and no statistical differences were shown between the groups (p>0.05). Nine knees complained of anterior knee pain and there was no difference between groups.
CONCLUSION
Lateral retinacular release in TKA may not be necessary if the patellar tracking is improved with the single stitch method after tourniquet deflation.

Keyword

knee; total knee arthroplasty; patellar tracking

MeSH Terms

Arthroplasty
Humans
Knee
Tourniquets
Track and Field

Figure

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  Figure 1 Measurement of the patellar tilting angle with the Merchant view of the knee joint.

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