Should the 'no thumb technique' be the golden standard for evaluating patellar tracking in total knee arthroplasty?

被引:21
作者
Cho, Woo-Shin [2 ]
Woo, Jae-Ho [2 ]
Park, Ho-Youn [2 ]
Youm, Yoon-Seok [1 ]
Kim, Byung-Kwan [3 ]
机构
[1] Univ Ulsan, Coll Med, Dept Orthoped Surg, Ulsan Univ Hosp, Ulsan 682714, South Korea
[2] Univ Ulsan, Coll Med, Dept Orthoped Surg, Asan Med Ctr, Seoul 138736, South Korea
[3] Hyemin Gen Hosp, Dept Orthoped Surg, Seoul 143190, South Korea
关键词
Total knee arthroplasty; No thumb technique; Towel clip technique; Tracking; Tilting; LATERAL RETINACULAR RELEASE; TOURNIQUET; SUBVASTUS; TILT;
D O I
10.1016/j.knee.2010.04.009
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
We checked intraoperative patellar tracking with both 'towel clip technique' and the 'no thumb technique' on 97 patients (167 knees) who underwent primary total knee arthroplasty to decide whether to do or not to do lateral retinacular release. Patellar tracking was assessed under pneumatic tourniquet with the no thumb technique first and re-evaluated with the towel clip technique. The tracking was graded as total contact, good contact, lateral contact and subluxation. The knees graded as total or good contact with the no thumb technique were classified into group A; those graded lateral contact or subluxation by the no thumb technique but total or good contact by the towel clip technique were classified into group B; and those graded lateral contact or subluxation by both techniques were classified into group C; in which lateral releases were performed. One hundred three, 53 and 11 knees were classified into groups A, B and C respectively. Of the 167 knees, 64 (38.3%) showed poor tracking (lateral contact or subluxation) with the no thumb technique alone. Re-evaluation of these knees with the towel clip technique significantly reduced the number with poor tracking to 11 (6.6%) knees requiring lateral retinacular release (p<0.05). The patients were followed up for 1 year without any patella-related complications occurring. Assessment of the patellar tracking using only the no thumb technique may overestimate the need for lateral retinacular release. The use of the no thumb technique as a screening test, and re-evaluation with the towel clip technique may reduce unnecessary lateral retinacular release. (C) 2010 Elsevier B.V. All rights reserved.
引用
收藏
页码:177 / 179
页数:3
相关论文
共 18 条
[1]
Indications for lateral retinacular release in total knee replacement [J].
Archibeck, MJ ;
Camarata, D ;
Trauger, J ;
Allman, J ;
White, RE .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2003, (414) :157-161
[2]
Patellar tilt and subluxation following subvastus and parapatellar approach in total knee arthroplasty - Implication for surgical technique [J].
Bindelglass, DF ;
Vince, KG .
JOURNAL OF ARTHROPLASTY, 1996, 11 (05) :507-511
[3]
Incidence of lateral release in total knee arthroplasty in standard and mini-incision approaches [J].
Cook, Jennifer L. ;
Scuderi, Giles R. ;
Tenholder, Mark .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2006, (452) :123-126
[4]
Engh GA, 1996, CLIN ORTHOP RELAT R, P56
[5]
GOMES LSM, 1988, CLIN ORTHOP RELAT R, P72
[6]
RADIOGRAPHIC ANALYSIS OF PATELLAR TILT [J].
GRELSAMER, RP ;
BAZOS, AN ;
PROCTOR, CS .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1993, 75 (05) :822-824
[7]
HOFMANN AA, 1991, CLIN ORTHOP RELAT R, P70
[8]
Influence of the pneumatic tourniquet on patella tracking in total knee arthroplasty - A prospective randomized study in 100 patients [J].
Husted, H ;
Jensen, TT .
JOURNAL OF ARTHROPLASTY, 2005, 20 (06) :694-697
[9]
Johnson D P, 1992, J Arthroplasty, V7 Suppl, P427, DOI 10.1016/S0883-5403(07)80035-0
[10]
Comparison of the vastus-splitting and median parapatellar approaches for primary total knee arthroplasty: A prospective, randomized study [J].
Kelly, MJ ;
Rumi, MN ;
Kothari, M ;
Parentis, MA ;
Bailey, KJ ;
Parrish, WM ;
Pellegrini, VD .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2006, 88A (04) :715-720