title: Freehand resection of the patella in total knee arthroplasty referencing the attachments of the quadriceps tendon and patellar tendon.
abstract: A freehand technique of patellar resurfacing using anatomic references was prospectively evaluated. This technique utilizes an osteotomy beginning at the inferior pole of the patella just posterior to the insertion of the patellar tendon and is carried proximally posterior to the insertion of the quadriceps tendon. Evaluation of 55 total knee arthroplasties in 41 patients showed an average restored patellar thickness within 0.1 mm. The overall patellar thickness was restored to within 1 mm of its preoperative thickness in 50 (91%) of 55 knees. Patellar tilt was equal to or less than 4 degrees in 42 (89%) of 47 arthroplasties evaluated radiographically. The patellar thickness averaged 17.9 mm, well above the critical value of 15 mm reported in the literature.
authors.affiliation: Joint Implant Surgeons, Inc., and Division of Orthopaedic Surgery, The Ohio State University, Columbus 43215, USA.
authors.forename: A V
authors.initials: AV
authors.lastname: Lombardi
authors.forename: T H
authors.initials: TH
authors.lastname: Mallory
authors.forename: P D
authors.initials: PD
authors.lastname: Maitino
authors.forename: S M
authors.initials: SM
authors.lastname: Herrington
authors.forename: C A
authors.initials: CA
authors.lastname: Kefauver
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D010329:Patella / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D011859:Radiography; D015203:Reproducibility of Results; D013709:Tendon Transfer / Q000379:methods; D013710:Tendons / Q000601:surgery*