title: The effect of medial release of the distal patellar tendon insertion on lateral patella translation and residual insertion strength: a cadaveric study.
abstract: Patellar tendon avulsion is a risk with difficult exposure in a stiff knee, patella baja or previous tibial osteotomy. We sought to define a safe amount of release of the patellar tendon insertion for such cases. Eleven pairs of fresh frozen cadaveric lower limb specimens were acquired and randomized to either intact or partial release of the distal tibial insertion. Partial release of the tibial insertion of the tendon increased lateral exposure a mean 29% ± 15% (P = 0.002) while reducing ultimate strength to a mean of 80% that of the intact contralateral tendon. Measured patella release increased lateral patella translation and can be performed without risk of catastrophic rupture with basic activities of daily living following TKA.
authors.affiliation: Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
authors.forename: Geoffrey F
authors.initials: GF
authors.lastname: Dervin
authors.affiliation: OrthoSport Victoria, Epworth Richmond, Richmond, Victoria, Australia; Austin Hospital, Heidelberg, Victoria, Australia.
authors.forename: Timothy
authors.initials: T
authors.lastname: Whitehead
authors.affiliation: Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
authors.forename: Phil
authors.initials: P
authors.lastname: Poitras
authors.affiliation: Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
authors.forename: Milton
authors.initials: M
authors.lastname: Parai
authors.affiliation: Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
authors.forename: Hakim
authors.initials: H
authors.lastname: Louati
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010329:Patella / Q000503:physiopathology / Q000601:surgery; D017847:Patellar Ligament / Q000033:anatomy & histology / Q000293:injuries / Q000503:physiopathology* / Q000601:surgery*; D011897:Random Allocation; D012421:Rupture; D013708:Tendon Injuries / Q000209:etiology / Q000503:physiopathology*
keywords: cadaver; patella tendon; tibial insertion; total knee arthroplasty