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The Journal of Bone and Joint Surgery (American) 85:S63-S70 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

The Patella in Revision Total Knee Arthroplasty

Aaron G. Rosenberg, MD, Joshua J. Jacobs, MD, Khaled J. Saleh, MD, MSc, FRCSC, Rida A. Kassim, MD, Michael J. Christie, MD, David G. Lewallen, MD, James A. Rand, MD and Harry E. Rubash, MD

Corresponding author: Aaron G. Rosenberg, MD
Department of Orthopaedic Surgery, Rush Medical College, 1725 West Harrison Street, £1063, Chicago, IL 60612-3828

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. One or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (Implex, Smith and Nephew). In addition, a commercial entity (Implex, Zimmer, Smith and Nephew) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

A video supplement to this article is available to our subscribers at no extra charge on the JBJS web site (www.jbjs.org), for a limited time. The same material is available for purchase from the Video Journal of Orthopaedics (www.vjortho.com; telephone: 805-962-3410).

The first 150 words of the full text of this article appear below.


   Introduction
 
The prevalence of patellofemoral complications following resurfacing in total knee arthroplasty has been reported to range from 4% to 41% 1,2. Complications related to the patellofemoral articulation are the cause of up to 45% of all total knee arthroplasty revisions 3 and 41% of re-revisions. Boyd et al. 1 showed an increased reoperation rate in patients in whom the patella was not resurfaced. This article will discuss the diagnosis and treatment of problems that occur at the patellofemoral articulation as well as issues related to the management of the patellofemoral joint and extensor mechanism during revision total knee arthroplasty, including evaluation of component fixation, assessment of compatibility of preexisting well-fixed components with revision implants, and management of patellar bone loss.


   Functional Biomechanics of the Patellofemoral Articulation
 
The extensor mechanism is composed of the quadriceps muscle and tendon, the patella, the patellar tendon, and their insertions into the tibial tuberosity. The patella functions in this mechanism as a pulley, . . . [Full Text of this Article]


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