Jai-Gon Seo1, Young-Wan Moon1, Sang-Min Kim2, Sang-Hoon Park3, Byung-Hoon Lee1, Moon-Jong Chang1, Byung-Chul Jo4. 1. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea. 2. Department of Orthopaedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea. 3. Department of Orthopaedic Surgery, National Health Insurance Service Ilsan Hospital, Ilsan, Korea. 4. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea. jbc2001@hanmail.net.
Abstract
PURPOSE: Pseudo-patella baja (PPB) is a surgical complication that can arise from total knee arthroplasty and occurs when the patella tendon is not shortened but the level of the femorotibial joint line is elevated. The goal of this study was to assess the performance of a technique specifically designed to prevent the occurrence of PPB and its radiological results. METHODS: Ninety-nine patients undergoing total knee arthroplasty were included. Patients were divided into a non-correction group and a correction group. The correction group were applied an additional metal block in order to reduce the excess resection of the distal femur. To evaluate PPB, the change in the pre- and postoperative joint line was measured using the modified Blackburne-Peel Index (BPI). RESULTS: In the non-correction group, 68 of 74 cases showed an occurrence of PPB (92 %), in the correction group, 6 of 57 cases showed an occurrence of PPB (11 %). The preoperative-modified BPI of the non-correction group was not significantly different from that of the correction group (0.6 ± 0.1 vs. 0.6 ± 0.2). The modified BPI decreased significantly in the non-correction group after TKA (0.6 ± 0.1 vs. 0.2 ± 0.1, p < 0.05). However, the modified BPI did not change significantly in the correction group after TKA (0.6 ± 0.2 vs. 0.6 ± 0.2). CONCLUSION: The comparison of preoperative and postoperative radiological results showed that our intervention maintained the joint line without elevation. We proposed an effective method to prevent various complications due to the joint line elevation that occur in PPB. LEVEL OF EVIDENCE: III.
PURPOSE: Pseudo-patella baja (PPB) is a surgical complication that can arise from total knee arthroplasty and occurs when the patella tendon is not shortened but the level of the femorotibial joint line is elevated. The goal of this study was to assess the performance of a technique specifically designed to prevent the occurrence of PPB and its radiological results. METHODS: Ninety-nine patients undergoing total knee arthroplasty were included. Patients were divided into a non-correction group and a correction group. The correction group were applied an additional metal block in order to reduce the excess resection of the distal femur. To evaluate PPB, the change in the pre- and postoperative joint line was measured using the modified Blackburne-Peel Index (BPI). RESULTS: In the non-correction group, 68 of 74 cases showed an occurrence of PPB (92 %), in the correction group, 6 of 57 cases showed an occurrence of PPB (11 %). The preoperative-modified BPI of the non-correction group was not significantly different from that of the correction group (0.6 ± 0.1 vs. 0.6 ± 0.2). The modified BPI decreased significantly in the non-correction group after TKA (0.6 ± 0.1 vs. 0.2 ± 0.1, p < 0.05). However, the modified BPI did not change significantly in the correction group after TKA (0.6 ± 0.2 vs. 0.6 ± 0.2). CONCLUSION: The comparison of preoperative and postoperative radiological results showed that our intervention maintained the joint line without elevation. We proposed an effective method to prevent various complications due to the joint line elevation that occur in PPB. LEVEL OF EVIDENCE: III.
Entities:
Keywords:
Complication; Patella; Total knee arthroplasty