[Influencing factors of the patella alignment in TKR and operative soft tissue management].
The patella has a crucial effect on the postoperative result after TKR, as complication statistics demonstrate. What factors influence the patella alignment and through which surgical steps can it be centred?


METHODS
Reviewing the findings from publications ranging from 1983 to 2000 and our own operative experience, we tried to establish all factors that could influence patella alignment after TKR.


RESULTS
A complex overview is given about the dependency of the patella alignment on the design of the prosthesis, the soft tissue and bone preparation and the implantation technique, together with suggestions for intraoperative management for patella centralisation.


CONCLUSIONS
To avoid any patella pathologies, it is of crucial importance to have comprehensive knowledge and to follow the described surgical steps strictly for patella centralisation, including the extensor mechanism. This is essential to achieve a satisfying functional result after TKR.
Büttner-Janz
K
K
Orthopädische Klinik, Klinikum Hellersdorf, Vivantes Netzwerk für Gesundheit GmbH, Berlin, Germany. orthopaedie@kh-hellersdorf.de
Ekkernkamp
A
A
D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010329:Patella / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011474:Prosthesis Design / Q000295:instrumentation*