Patellar dislocation after total knee Arthroplasty: Stabilization technique using medial flap and suture anchors

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-08-18 DOI:10.1016/j.jor.2025.08.026

Walter F. Martínez , Luis Camacho Terceros , Ezequiel Becker , Florencia Garbini , Eduardo J. Bochatey , Fernando A. Lopreite

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引用次数: 0

Abstract

Introduction

Patellar dislocation following total knee arthroplasty (TKA) is an uncommon but functionally significant complication. Its management requires careful evaluation of prosthetic alignment, patellofemoral mechanics, and soft tissue integrity. The aim of this study was to describe a surgical stabilization technique using a medial retinacular flap fixed to the patella with suture anchors, combined with controlled lateral retinacular release, and to analyze its clinical and functional outcomes.

Materials and methods

We conducted a retrospective case series between 2011 and 2023 in two specialized orthopedic centers. Fourteen patients with patellar dislocation after primary TKA—without prosthetic loosening or significant malrotation—were included. Clinical evaluation included pain (VAS), function (Lysholm score), satisfaction (Likert scale), and return to daily activities. Mean follow-up was 8.3 years.

Results

All patients achieved a functional range of motion (≥0°–100°) without recurrence or instability. Lysholm scores improved significantly from 46.4 ± 3.05 to 83.8 ± 5.85 (p < 0.0001), and VAS pain scores decreased from 6.0 ± 0.71 to 1.2 ± 0.84 (p = 0.0012). No infections, hematomas, or reoperations were recorded. Overall satisfaction was high, with 85.7 % of patients reporting being satisfied or very satisfied.

Conclusion

The medial flap technique with suture anchor fixation is effective, reproducible, and low in morbidity. It represents a safe and less invasive alternative for the treatment of patellar dislocation following TKA in patients without mechanical failure.

Level of evidence

IV. Case series.

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全膝关节置换术后髌骨脱位：内侧皮瓣和缝合锚钉的稳定技术

全膝关节置换术（TKA）后髌骨脱位是一种少见但功能上重要的并发症。其治疗需要仔细评估假体对齐、髌股力学和软组织完整性。本研究的目的是描述一种手术稳定技术，使用缝合锚钉固定髌骨内侧支持带瓣，结合控制外侧支持带释放，并分析其临床和功能结果。材料与方法我们在2011年至2023年在两个专业骨科中心进行回顾性病例系列研究。纳入14例原发性tka后髌骨脱位患者，无假体松动或明显旋转不良。临床评价包括疼痛（VAS）、功能（Lysholm评分）、满意度（Likert量表）和日常活动恢复情况。平均随访时间8.3年。结果所有患者均达到功能性活动范围（≥0°-100°），无复发或不稳定。Lysholm评分由46.4±3.05分显著提高至83.8±5.85分（p < 0.0001）， VAS疼痛评分由6.0±0.71分显著降低至1.2±0.84分（p = 0.0012）。无感染、血肿或再手术记录。总体满意度很高，85.7%的患者表示满意或非常满意。结论内侧皮瓣缝合锚钉固定术疗效好，可重复性好，发病率低。它代表了一种安全的，侵入性较小的替代治疗髌骨脱位后，TKA患者无机械故障。证据水平：系列。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.