TKR: Patellar Eversion

- Discussion:
    - the patella should evert with minimal tension on the patella tendon;
    - methods to facilitate patellar eversion:
          - patellar resurfacing:
                - patellar resurfacing can be performed early in the exposure inorder to thin the patella and facilitate the eversion;
          - proximally ensure that there is an adequate quadriceps incision;
                - in revision TKR, a quadriceps snip may be required;
                - transect any adhesions in the in the suprapatella pouch;
          - distally ensure that the entire patellar tendon has been exposed;
                - it is permissible to sharply elevate a small amount (10-20%) of the patellar tendon off its insertion (rather than
                        have it partially avulse under tension);
          - incise the anterior attachements of the lateral mensicus of the tibia;
          - ensure that an adequate lateral capsular exposure has been performed;
          - excise patello-femoral ligaments:
                - attach a Kocher clamp to cuff of retinaculum attached to medial side of patella;
                - retract the Kocher to partially evert the patella so that the patellofemoral ligaments are placed under tension;
                - use curved Mayo's to spread under the patellofemoral ligament and then incise it;
          - lateral retinacular release

Does Patellar Eversion in Total Knee Arthroplasty Cause Patella Baja?

Avoidance of patellar eversion improves range of motion after total knee replacement: a prospective randomized study

Patellar Eversion During Total Knee ReplacementA Prospective, Randomized Trial

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, February 10, 2014 11:22 am