Significance and issues of patellar replacement in total knee arthroplasty
10.3969/j.issn.1673-8225.2009.48.023
- VernacularTitle:髌骨置换在全膝关节置换中的意义及存在问题
- Author:
Puwei YUAN
;
Hua CHEN
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2009;13(48):9503-9506
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: The question whether patellar replacement is necessary during total knee arthroplasty remains controversial. The influence of different parameters, such as patellar thickness, bone bed shape, fixation column style and fixation patterns on effect of total knee arthroplasty remains unclear. OBJECTIVE: To induce the technical parameters in patellar replacement. METHODS: A computer-based line seerch of CNKI and Pubmend was performed for articles published between January 1999 and June 2009 with key words "artificial knee joint, petellar replacement" in Chinese and "artificial knee joint, arthroplasty, patellar surfacing" in English. Clinical studies of patients undergoing patellar replacement or not dudng total knee arthroplasty were included. Animal experiments were excluded. The indication and complication of patellar replacement, issues regarding patellar replacement, influence of petellar thickness reservation on artificial knee arthroplasty, prosthesis design of patellar and influence of internal fixation pattems on postoperative effect, and influence of replacement techniques on artificial knee joint were discussed in this article. RESULTS AND CONCLUSION: Currently, patellar replacement is considered to have three patterns: total replacement, no replacement and selective replacement. The shape of patella remains controversial. Bone cement is commonly used for patellar prosthesis fixation. The pdnciples of patellar replacement are as follows: to maximize patellar thickness; to maintain articular facet symmetry; to protect patellar blood transport; to ensure reasonable motion track of the patella. The indications of patellar replacement depend on protopathy, pathological change degree, prosthesis pattern, patient activity amount and body mass.
