title: The influence of femoral component design in the elimination of patellar clunk in posterior-stabilized total knee arthroplasty.
abstract: Patellar clunk occurs after posterior-stabilized total knee arthroplasty and is believed to be a design-related complication. This study was undertaken to define the incidence of patellar clunk with an optimized third-generation, posterior-stabilized prosthesis. One hundred ninety three patients with 238 knees were evaluated at a minimum of 2 years after primary total knee arthroplasty with a cemented, NexGen Legacy Posterior-Stabilized prosthesis (Zimmer, Warsaw, Ind). The mean follow-up was 48 months (range, 24-72 months). No patient manifested symptoms of patellar clunk or underwent surgery for any patello-femoral problem. These results support prior evidence that femoral component design is the primary cause of patellar clunk and that modifications incorporated into this third-generation, posterior-stabilized prosthesis has eliminated the problem.
authors.affiliation: Department of Orthopedics, Mayo Clinic, Scottsdale, Arizona 85259, USA.
authors.forename: Henry D
authors.initials: HD
authors.lastname: Clarke
authors.forename: Robin
authors.initials: R
authors.lastname: Fuchs
authors.forename: Giles R
authors.initials: GR
authors.lastname: Scuderi
authors.forename: Edward L
authors.initials: EL
authors.lastname: Mills
authors.forename: William N
authors.initials: WN
authors.lastname: Scott
authors.forename: John N
authors.initials: JN
authors.lastname: Insall
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D005269:Femur; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011474:Prosthesis Design