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Stability of capsule closure and postoperative anterior knee pain after medial parapatellar approach in TKA
- Source :
- Archives of Orthopaedic and Trauma Surgery. 137:1019-1024
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- Anterior knee pain after total knee arthroplasty (TKA) remains a widely discussed postoperative complication. In contrast to sports traumatology, the role of the dissected medial patellofemoral ligament (MPFL) using a medial parapatellar approach in TKA has not been discussed so far. In the present study, it was hypothesized that the attempted repair of the MPFL in TKA by simple closure of the joint capsule may not be successful in some cases, causing anterior knee pain. Furthermore, it was hypothesized, that the success of repair might be influenced by femoral component rotation. Forty patients received their TKA in a ligament-balanced and forty patients in a conventional measured-resection technique. After implantation of the TKA using a medial parapatellar approach, two titan clips were attached on both sides of the capsule incision. 3 days and 3 months after surgery, the dehiscence of the two clips was measured on skyline patella radiographs; additionally patellar tilt, shift, the Knee Society Score and the Feller Score were obtained. 48 patients showed an increase of capsule dehiscence. Patients with a capsule dehiscence of more than 4 mm showed significantly less improvement in the Feller score 3 months postoperatively than patients with a capsule dehiscence ≤4 mm. Regarding the radiological measurements and the clinical outcome, no significant difference between the ligament-balanced and the measured-resection group was found. The present results suggest that the successful repair of the MPFL after using a medial parapatellar approach in TKA could reduce the high rate of postoperative anterior knee pain. Furthermore, the appearance of capsule dehiscence and anterior knee pain does not seem to be dependent on the used operative technique.
- Subjects :
- Adult
Male
musculoskeletal diseases
medicine.medical_specialty
Knee Joint
Rotation
Traumatology
Medial patellofemoral ligament
Dehiscence
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Germany
Joint capsule
medicine
Humans
Orthopedics and Sports Medicine
030212 general & internal medicine
Arthroplasty, Replacement, Knee
Aged
Aged, 80 and over
Pain, Postoperative
030222 orthopedics
business.industry
Postoperative complication
Capsule
Patella
General Medicine
Middle Aged
musculoskeletal system
Surgery
medicine.anatomical_structure
Orthopedic surgery
Female
business
Subjects
Details
- ISSN :
- 14343916 and 09368051
- Volume :
- 137
- Database :
- OpenAIRE
- Journal :
- Archives of Orthopaedic and Trauma Surgery
- Accession number :
- edsair.doi.dedup.....a945571a243fcd8bb41da413e2618e04