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Replacement of the patello-femoral joint with the total condylar knee arthroplasty

Summary

We have studied 241 total condylar knee arthroplasties with replacement of the articular surface of the patella in 206 patients. The average age was 65 years.

The technique of replacement of the patellofemoral joint emphasises realignment of the quadriceps mechanism, minimal excision of the patella to preserve subchondral bone, preservation of soft tissue attachments including the infrapatellar fat pad, and closure of the quadriceps without tension.

The results of replacement have been good to excellent in 95 per cent of patients followed for two years or more. There were no subluxations, dislocations or fractures. Loosening was noted in one case associated with anterior knee pain. Discomfort was also noted with eccentric placement of the prosthesis where bone was left uncovered.

We consider that routine replacement of the patello-femoral joint is advisable with total condylar knee arthroplasty.

Résumé

Etude de 241 arthroplasties totales du genou avec remplacement de la surface articulaire rotulienne, pratiquées sur 206 malades dont l'âge moyen était de 65 ans.

En ce qui concerne la technique du remplacement rotulien, il faut insister sur le réalignement du tendon quadricipital, sur une résection limitée de la rotule afin de conserver l'os sous-chondral, sur la préservation des parties molles péri-rotuliennes y compris le ligament adipeux et sur la suture sans tension du quadriceps.

Les résultats du remplacement rotulien ont été excellents ou bons chez 95% des opérés, suivis deux ans ou plus. Il n'y a eu ni subluxations, ni luxations, ni fractures. Un seul cas de descellement a été observé, s'accompagnant de douleurs à la face antérieure du genou. Une gêne a également été notée lorsque la prothèse a été placée en position excentrique, là où l'os était resté découvert.

On peut donc recommander l'utilisation systématique de la prothèse rotulienne au cours de l'arthroplastie du genou par prothèse «total condylar».

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Correspondence to Chitranjan S. Ranawat.

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Ranawat, C.S., Rose, H.A. & Bryan, W.J. Replacement of the patello-femoral joint with the total condylar knee arthroplasty. International Orthopaedics 8, 61–65 (1984). https://doi.org/10.1007/BF00267742

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Key words

  • Patello-femoral joint replacement
  • Total condylar knee arthroplasty