Anterior knee pain after total knee arthroplasty: a narrative review

被引:206
作者
Petersen, Wolf [1 ]
Rembitzki, Ingo Volker [2 ]
Brueggemann, Gerd-Peter [3 ]
Ellermann, Andree [4 ]
Best, Raymond [5 ]
Goesele-Koppenburg, Andreas [6 ]
Liebau, Christian [2 ]
机构
[1] Martin Luther Krankenhaus, Klin Orthopadie & Unfallchirurg, D-14193 Berlin Grunewald, Germany
[2] Asklepios Harzkliniken GmbH Fritz Konig Stift, Bad Harzburg, Germany
[3] Deutsch Sporthochsch Koln, Inst Biomech, Cologne, Germany
[4] Arcus Sportklin, Pforzheim, Germany
[5] Sportklin, Stuttgart, Germany
[6] Cross Klin Basel, Olymp Med Ctr, Basel, Switzerland
关键词
Patellar instability; Rotational error; Dynamic valgus; Functional malalignment; Patellar maltracking; SYMPTOMATIC PATELLOFEMORAL MALALIGNMENT; FEMORAL COMPONENT DESIGN; PATIENT SATISFACTION; QUADRICEPS STRENGTH; LATERAL RETINACULUM; PATELLAR VIABILITY; RESIDUAL PAIN; HIP ABDUCTOR; REPLACEMENT; METAANALYSIS;
D O I
10.1007/s00264-013-2081-4
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Anterior knee pain is one of the most common causes of persistent problems after implantation of a total knee replacement. It can occur in patients with or without patellar resurfacing. As a result of the surgical procedure itself many changes can occur which may affect the delicate interplay of the joint partners in the patello-femoral joint. Functional causes of anterior knee pain can be distinguished from mechanical causes. The functional causes concern disorders of inter- and intramuscular coordination, which can be attributed to preoperative osteoarthritis. Research about anterior knee pain has shown that not only the thigh muscles but also the hip and trunk stabilising muscles may be responsible for the development of a dynamic valgus malalignment. Dynamic valgus may be a causative factor for patellar maltracking. The mechanical causes of patello-femoral problems after knee replacement can be distinguished according to whether they increase instability in the joint, increase joint pressure or whether they affect the muscular lever arms. These causes include offset errors, oversizing, rotational errors of femoral or tibial component, instability, maltracking and chondrolysis, patella baja and aseptic loosening. In these cases, reoperation or revision is often necessary.
引用
收藏
页码:319 / 328
页数:10
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