– Discussion: – avulsion of the patella tendon is a serious complication that is very difficult to treat; – when the knee is flexed intraoperatively, the tendon insertion may be stressed to the point of partial or complete avulsion; – this is particularly true in patients who have had a HTO … Read more
– Debride Bone Edges: – Drill and Pass Sutures: – note that many surgeons will prefer to make bone plug drill holes before the plug is harvest w/ a saw; – use a 2 mm drill to make three drill holes into the graft for the tibial tunnel … Read more
– Skin Incision: – 5-7 cm incision is made from inferior patellar pole to a point just medial to the tibial tubercle; – incision is taken down thru skin and subcutaneous tissues using scalpel; *** *** – Incising the Patellar Tendon: … Read more
– See: Radiograhpic Evaluation – Anatomy – Biomechanics – Multipartite Patella – Chondromalacia – Dislocation of the Patella – Examination of the Patellofemoral Joint – Fractures of the Patella – Jumper’s Knee – Lateral Retinacular Release – Patella Alta – Pathology – Patella … Read more
– 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 … Read more
– See: – Extensor Mechanism Injuries of the Knee – Quadriceps – Patellar Tendon Avulsion from TKR – Discussion: – usually occur in pts under age of 40; – most ruptures occur w/ the knee in a flexed position (around 60 deg) which are then … Read more
– See: TKR Menu – Discussion: – anatomy / q angle – blood supply to the knee – indications for patellar resurfacing – design and function of the patellar component in TKR: – effects of component rotation – Patellar Resurfacing: (technique) – indications for patellar resurfacing – lateral retinacular release: – Non Resurfaced Patella Considerations: … Read more
– See: Patella Alta – Discussion: – patella infera indicates an abnormally low patella; – it most often results from to soft tissue contracture and hypotonia of quadriceps muscle following surgery or trauma to knee, – Lateral Radiograph of the Knee: – is used to determine patellar height; – … Read more
– See: – Malposition of Joint Line: – Patellar Clunk Syndrome: – Discussion: – more frequent than patella alta; – data suggest that maintenance of a ht between 10 and 30 mm is optimal – this problem may be prevented by keeping resection … Read more
– Discussion: – not all patellar fractures are amenable to ORIF; – in most cases of patellar frx, one large frag of patella can be preserved; – most often the distal pole is comminuted, whereas superior pole is intact,however, as a principle, the larger fragment … Read more