BACKGROUND: Maltracking or subluxation is one of the complications of patellofemoral arthroplasty. QUESTIONS/PURPOSES: We questioned whether the computed navigation system can improve patellar tracking in patients with patellofemoral arthroplasty (PFA). METHODS: Between 2007 and 2010 we performed 15 patellofemoral arthroplasties using the Ceraver PFA and navigation assistance. Fifteen other patients underwent surgery without navigation during the same period and acted as a control group. The rotation of the native trochlea as measured using the epicondylar line as a reference before surgery and the rotation of the trochlear component and the trochlear twist angle were assessed with computed tomography (CT) scan after surgery. RESULTS: The mean follow-up was 3 years (range, 2-5 years). The group with navigation had no patellofemoral complications and better clinical scores. The group without navigation had abnormal patellofemoral tracking in 5 of the 15 patients. CT scan demonstrated excessive internal component rotation, as compared with patients without complications. This excessive internal rotation was proportional to the severity of the patellofemoral maltracking. CONCLUSIONS: The short-term results suggest that navigation can lead to better trochlear rotation which, in our hands, is associated with fewer cases of patellar maltracking and better overall clinical scores.
BACKGROUND: Maltracking or subluxation is one of the complications of patellofemoral arthroplasty. QUESTIONS/PURPOSES: We questioned whether the computed navigation system can improve patellar tracking in patients with patellofemoral arthroplasty (PFA). METHODS: Between 2007 and 2010 we performed 15 patellofemoral arthroplasties using the Ceraver PFA and navigation assistance. Fifteen other patients underwent surgery without navigation during the same period and acted as a control group. The rotation of the native trochlea as measured using the epicondylar line as a reference before surgery and the rotation of the trochlear component and the trochlear twist angle were assessed with computed tomography (CT) scan after surgery. RESULTS: The mean follow-up was 3 years (range, 2-5 years). The group with navigation had no patellofemoral complications and better clinical scores. The group without navigation had abnormal patellofemoral tracking in 5 of the 15 patients. CT scan demonstrated excessive internal component rotation, as compared with patients without complications. This excessive internal rotation was proportional to the severity of the patellofemoral maltracking. CONCLUSIONS: The short-term results suggest that navigation can lead to better trochlear rotation which, in our hands, is associated with fewer cases of patellar maltracking and better overall clinical scores.
Authors: Mo Saffarini; Jacobus H Müller; Giuseppe La Barbera; Gerjon Hannink; Kyung Jin Cho; Cécile Toanen; David Dejour Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-03-07 Impact factor: 4.342