Primary Total Knee Arthroplasty for Treating Osteoarthritic Knees with Neglected Patellar Dislocation

被引:0
|
作者
Kim, Sung Eun [1 ]
Kim, Seong Hwan [2 ]
Lee, Jung-In [1 ]
Han, Hyuk-Soo [1 ]
Lee, Myung Chul [1 ]
Ro, Du Hyun [1 ]
机构
[1] Seoul Natl Univ Hosp, Dept Orthoped Surg, Seoul 03080, South Korea
[2] Chung Ang Univ Hosp, Dept Orthoped Surg, Seoul 06973, South Korea
来源
MEDICINA-LITHUANIA | 2024年 / 60卷 / 09期
关键词
total knee arthroplasty; osteoarthritis; neglected patellar dislocation; outcomes; CONGENITAL DISLOCATION; MANAGEMENT;
D O I
10.3390/medicina60091492
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and Objectives: Neglected patellar dislocation in the presence of end-stage osteoarthritis (OA) is a rare condition characterized by the patella remaining laterally dislocated without reduction. Due to the scarcity of reported cases, the optimal management approach is still uncertain. However, primary total knee arthroplasty (TKA) can serve as an effective treatment option. This study aimed to present the clinical and radiological outcomes achieved using our surgical technique. Materials and Methods: A retrospective review of 12 knees in 8 patients with neglected patellar dislocation and end-stage OA who underwent primary TKA was conducted. The surgical procedure involved conventional TKA techniques (e.g., medial parapatellar arthrotomy) and additional procedures specific to the individual pathologies of neglected patellar dislocation (e.g., lateral release, medial plication, and quadriceps lengthening). Clinical outcomes, including patient-reported outcome measures (PROMs) (Knee Society Scores and the Western Ontario and McMaster Universities Osteoarthritis Index) and knee range of motion (ROM), were assessed preoperatively and two years postoperatively. Radiological measures including mechanical femorotibial angle and patellar tilt angle were assessed preoperatively and until the last follow-up examinations. Any complications were also reviewed. Results: There were significant improvements in all PROMs, knee ROM, and radiological outcomes, including mechanical femorotibial angle and patellar tilt angle (all p < 0.05). At a mean follow-up of 68 months, no major complications requiring revision surgery, including patellar dislocation, were reported. Conclusions: Primary TKA is an effective procedure for correcting various pathologies associated with neglected patellar dislocation in end-stage OA without necessitating additional bony procedures. Satisfactory clinical and radiological outcomes can be expected using pathology-specific procedures.
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页数:11
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