- Discussion:
- if patient is able to flex beyond 120 deg and if scar forms on quad tendon, this scar may be carried into notch of femoral component;
- when the patient extends the knee (especially against resistance such as rising from a chair) the fibrotic nodule catches on the anterior
edge of the femoral component;
- scar eventually releases w/ a painful clunk, allowing leg to extend;
-
risk factors:
- common in
posterior stabilized TKR;
-
patella infera is a risk factor;
- Clinical Presentation:
- pt may report loosening, dislocation, or giving out because the patella catches during extension and tracks roughly;
- Treatment:
-
arthroscopic resection of the offending scar tissue;
The patellar "clunk" syndrome after posterior stabilized total knee arthroplasty.
Arthroscopic managment of the patellar clunk syndrome following posterior stabilized total knee arthroplasty. JV Vernace et al.
J. Arthroplasty. Vol 4. 1989. p 179-182.
The patellar clunk syndrome: A complication of posterior stabilized total knee arthroplasty. WJ Hozack et al.
CORR. Vol 241. 1989. p 203-208.
Synovial Entrapment: A Complication of Posterior Stabilized Total Knee Arthroplasty.
The patellar "clunk" syndrome after posterior stabilized total knee arthroplasty.
Intra-articular fibrous bands. Patellar complications after total knee replacement.
