Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2010 Apr;45(2):133-138. Korean.
    Published online Apr 19, 2010.
    https://doi.org/10.4055/jkoa.2010.45.2.133
    Copyright © 2010 by The Korean Orthopaedic Association
    Original Article

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

    Yoon-Seok Youm, M.D., Sung-Do Cho, M.D., Chang-Yoon Jung, M.D. and Han-Chang Park, M.D.
      • Department of Orthopedic Surgery, Arthro-center, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea.
    • Correspondence to: Sung-Do Cho, M.D. Department of Orthopedic Surgery, Ulsan University Hospital, 290-3 Jeonha-dong, Dong-gu, Ulsan 682-714, Korea. TEL: +82-52-250-7129, FAX: +82-52-235-2823, Email: sdcho@uuh.ulsan.kr
    Received October 07, 2009; Accepted December 29, 2009.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    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 4.1°, 3.4°, 5.1° and 4.3° 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.

    Keywords
    knee; total knee arthroplasty; patellar tracking

    Figures

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

    Tables

    Table 1
    Patellar Tilt Angle, Knee Society Knee and Function Score according to the Groups

    Table 2
    Feller's Patellar Score

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    MeSH Terms
    Arthroplasty
    Humans
    Knee
    Tourniquets
    Track and Field
    Metrics
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