Clinical Value of "The Single Stitch Method" in Intraoperative Assessment of Patellar Tracking in Total Knee Arthroplasty / 대한정형외과학회잡지

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 4.1degrees, 3.4degrees, 5.1degrees and 4.3degrees 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.