title: Arthroscopic treatment of soft-tissue impingement under the patella after total knee arthroplasty.
abstract: There has been an increased number of reports of complicated diseases of the patellofemoral joints after total knee arthroplasty (TKA). We treated soft-tissue impingement under the patella after TKA by arthroscopic surgery and investigated the findings and efficacy of the treatment. Six patients and 8 knees that showed soft-tissue impingement of patellofemoral joints after TKA were treated by arthroscopic surgery. We classified the patients with soft-tissue impingement under the patella into 3 groups: (I) patellar clunk syndrome, the isolated fibrous nodule located in the suprapatellar lesion without the other fibrous tissues causing the impingement (n = 2); (II) impinging hypertrophic synovitis, generalized hypertrophic synovitis with no fibrous nodule (n = 4); and (III) the combination of types I and II, the suprapatellar fibrous nodule with generalized hypertrophic synovitis (n = 2). Therapeutic efficacy was in type I, 2 were good to excellent; in type II, 3 were fair and 1 was poor; and in type III, 2 were fair. Better results were obtained in type I (a patellar clunk syndrome) than in type II (impingement synovitis).
authors.affiliation: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan. taka1m@hama-med.ac.jp
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Shigehito
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Akira
authors.initials: A
authors.lastname: Nagano
mesh_terms: D018771:Arthralgia / Q000209:etiology / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D006801:Humans; D010329:Patella / Q000601:surgery; D017847:Patellar Ligament / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*; D011475:Prosthesis Failure; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013585:Synovitis / Q000601:surgery