Radiological Approach to Assessment of Lower-Limb Alignment-Coronal and Transverse Plane Analysis.

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Abstract

Conflict of interest statement: The authors declare no conflicts of interest. 11. Joints. 2013 Jun 12;1(1):10-7. eCollection 2013 Mar. Patellar malalignment treatment in total knee arthroplasty. Gasparini G(1), Familiari F(1), Ranuccio F(1). Author information: (1)Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University of Catanzaro, Italy. The patella, with or without resurfacing, plays a fundamental role in the success of a total knee arthroplasty (TKA). Patellofemoral joint complications are due to problems related to the patient, to the surgical technique, or to the design of the components. Patellar tracking is influenced by several factors: a severe preoperative valgus, the presence of pre-existing patellofemoral dysplasia, the design of the femoral component, the surgical approach, the Q angle, the mechanical alignment of the limb, the tightness of the lateral retinaculum, the positioning of the patellar component in the proximal-distal and medial-lateral directions, the patella height, the patella (native or resurfaced) thickness, the size of the femoral and the tibial components, and the alignment and rotation of the components. Several factors are crucial to prevent patellar maltracking in TKA: the use of an anatomical femoral component, a meticulous surgical technique, careful dynamic intraoperative assessment of patellar tracking, and, if necessary, the achievement of an adequate lateral release. PMCID: PMC4295689