Bi-cruciate retaining total knee arthroplasty: a systematic literature review of clinical outcomes.

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Abstract

[Indexed for MEDLINE] 13. Orthop Traumatol Surg Res. 2023 Feb;109(1S):103458. doi: 10.1016/j.otsr.2022.103458. Epub 2022 Oct 24. How to optimize patellar tracking in knee arthroplasty? Lustig S(1), Servien E(2), Batailler C(2). Author information: (1)Service de chirurgie orthopédique et médecine du sport, centre d'Excellence FIFA, hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France. Electronic address: Sebastien.lustig@gmail.com. (2)Service de chirurgie orthopédique et médecine du sport, centre d'Excellence FIFA, hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France. Good patellar tracking is needed for functionally successful total knee arthroplasty (TKA), and depends on several factors. The aim of the present Instructional Lecture is to identify the main factors and how to control them so as to optimize patellar tracking: more or less "patella-friendly" prosthetic trochlea design, requiring precise assessment and choice of model; patellar component design; type of tibial implant; surgical approach and management of peripatellar structures, and any lateral release; distal and posterior femoral bone cuts, determining femorotibial alignment, femoral component rotation and patellar height; tibial implant rotation with respect to the anterior tibial tubercle; patellar cut characteristics in resurfacing. In case of instability or patellar maltracking despite correct implant positioning, there are 2 main surgical techniques: medial patellofemoral ligament reconstruction, and anterior tibial tubercle medialization. To obtain optimal patellar tracking, correction of other factors should be associated: trochlear component design, distal and posterior femoral bone cuts, tibial implant positioning, patellar component shape and positioning, etc. Copyright © 2022 Elsevier Masson SAS. All rights reserved. DOI: 10.1016/j.otsr.2022.103458