title: Fulkerson procedure for chronic patella component dislocation after total knee arthroplasty.
abstract: Chronic patella component dislocation after primary knee arthroplasty can be a challenging problem. The purpose of this case series was to review our results of a chronic patella dislocation after total knee arthroplasty treated with a Fulkerson procedure (anteromedialization of the tibial tubercle). Five patients with an average age of 68.8 years (range, 60-76 years) underwent a Fulkerson procedure to restore extensor mechanism alignment. The tibial tubercle osteotomy was secured with lag screws with an average medialization of approximately 1.5 cm. The average preoperative Knee Society score was 70.5 points that improved to 85 points postoperatively. The average knee flexion was 93 degrees preoperatively that improved to 101 degrees postoperatively. Adequate patellofemoral alignment was achieved in all patients along with union of the tibial tubercle osteotomy site. The Fulkerson procedure appears to be an excellent treatment option in patients with a chronically dislocated patella component after total knee arthroplasty.
authors.affiliation: Department of Orthopedic Surgery, University of Louisville, Louisville, Kentucky, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Price
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Malkani
authors.forename: Dale
authors.initials: D
authors.lastname: Baker
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D017760:Bone Malalignment / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D031222:Patellar Dislocation / Q000601:surgery*; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome