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The Journal of Bone and Joint Surgery, Vol 68, Issue 7 1035-1040, Copyright © 1986 by Journal of Bone and Joint Surgery, Inc
The influence of tibial-patellofemoral location on function of the knee in patients with the posterior stabilized condylar knee prosthesis
HE Figgie, VM Goldberg, KG Heiple, HS Moller and NH Gordon
Function of the knee and patellofemoral symptoms were correlated with the
position of the implant in 101 consecutive patients with 116 posterior
stabilized condylar knee prostheses. All of the patients were followed for
a minimum of two and a half years with sequential physical examinations,
radiographs, and functional evaluation of the knee. In sixteen knees (14
per cent), clicking or catching of the patella in terminal extension or
painless crepitation throughout the arc of flexion developed without
lowering the functional knee-evaluation score. Pain or mechanical problems,
or both, that lowered the functional knee-evaluation score occurred in
another fourteen knees (12 per cent), within the first postoperative year.
Of these fourteen, eight required revision solely for patellofemoral
complaints. Critical analysis of the tibial-patellofemoral mechanical axis
identified three surgical variables that were found to markedly affect the
functional result of the prosthesis: the distance from the center line of
the tibial prosthesis to the center line of the tibial plateau, a change in
the position of the joint line of the prosthesis relative to the hip and
ankle, and the patellar height, measured as the perpendicular distance from
the inferior pole of the patellar implant to the joint line of the
prosthesis. Functional knee scores, range of motion, patellofemoral pain or
mechanical symptoms, the need for revision, and the necessity of
manipulation could all be statistically significantly correlated with the
three independent variables. In addition, a range of neutral alignment was
developed.(ABSTRACT TRUNCATED AT 250 WORDS)
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