Clinical Value of

Yoon-Seok Youm; Sung-Do Cho; Chang-Yoon Jung; Han-Chang Park

doi:10.4055/jkoa.2010.45.2.133

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Youm, Cho, Jung, and Park: Clinical Value of "The Single Stitch Method" in Intraoperative Assessment of Patellar Tracking in Total Knee Arthroplasty

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2010; 45(2): 133-138.

Published online: 19 April 2010

DOI: https://doi.org/10.4055/jkoa.2010.45.2.133

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., 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, sdcho@uuh.ulsan.kr

Received 7 October 2009 Accepted 29 December 2009

(open-access):

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 and Tables

Figure 1

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

Table 1

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

No statistical differences were shown between the groups (p>0.05). However, Knee Society knee and function scores were significantly improved in all groups (p<0.05).

Table 2

Feller's Patellar Score

No statistical difference was shown between the groups (p>0.05).

However, the score was significantly improved in all groups (p<0.05).

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