title: A new patellofemoral scoring system for total knee arthroplasty.
abstract: Patellofemoral complications after total knee arthroplasty (TKA) can result in substantial dissatisfaction with the procedure for some patients. In assessing outcomes of TKA, however, there is often a discrepancy between patellofemoral symptoms and the results obtained by conventional scoring and radiographic analysis. We asked whether a new scoring system and weightbearing radiographic view would more accurately represent patellofemoral kinematics and explain related complications. Sixty-nine patients (100 knees) who underwent posterior-stabilized TKA between 1994 and 1997 were included for clinical and radiographic evaluation. A new patella score was developed to rapidly determine complications, ranged from 0 to 100 points, and included ratings for subjective and objective aspects of TKA. A new weight-bearing axial radiographic view was devised by positioning the standing patient in a semisquatted position. Measurements for patella alignment (tilt and subluxation) were performed. Preoperative Knee Society knee and function scores were 43 +/- 5 points, and 39 +/- 15 points, respectively. Postoperatively, scores increased to 93 +/- 8 and 89 +/- 8 points, respectively. The patella score averaged 89 +/- 8 points and showed satisfactory interobserver variability. The new weightbearing radiographic view demonstrated sources of patellofemoral symptoms. We report a new scoring system and weightbearing view that are easy to use and more accurately represent patellofemoral kinematics than do conventional methods of analysis.
authors.affiliation: Hospital for Special Surgery, New York, NY, USA. drbaldiniandrea@yahoo.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Baldini
authors.forename: John A
authors.initials: JA
authors.lastname: Anderson
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Zampetti
authors.forename: Helene
authors.initials: H
authors.lastname: Pavlov
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Sculco
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D001696:Biomechanical Phenomena; D005269:Femur; D006801:Humans; D010146:Pain / Q000209:etiology; D010329:Patella / Q000000981:diagnostic imaging*; D011183:Postoperative Complications / Q000175:diagnosis; D011859:Radiography