title: Incidence of patellar clunk syndrome in fixed versus high-flex mobile bearing posterior-stabilized total knee arthroplasty.
abstract: The geometry of the intercondylar box plays a significant role in the development of patellar clunk syndrome. We reviewed the incidence of patella clunk at mid-to-long-term follow-up of a rotating high-flex versus fixed bearing posterior stabilized TKA design. 188-mobile and 223-fixed bearing TKAs were reviewed for complications, incidence of patellar clunk, treatment, recurrence rates, range of motion, and patient satisfaction. Patellar clunk developed in 22 knees in the mobile (11.7%) and in 4 (1.8%) in the fixed bearing group (P<0.001). 23 out of 26 cases resolved with a single arthroscopic treatment and 2 resolved with a second procedure. The mean postoperative range of motion was 122.4°. All but one patient reported overall satisfaction with the index procedure. In contrast with other recent studies we found a significant incidence of patellar clunk in high-flex mobile bearings. Despite the high rate of patellar clunk syndrome, overall patients did well and were satisfied with their outcomes.
authors: Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York.
authors: Nimrod
authors: N
authors: Snir
authors: Department of Orthopaedic Surgery, University of California Irvine Medical Center, Orange, California.
authors: Ran
authors: R
authors: Schwarzkopf
authors: Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York.
authors: Brian
authors: B
authors: Diskin
authors: Department of Orthopaedic Surgery, Kauai Medical Clinic, Wilcox Hospital, Lihue, Hawaii.
authors: Richelle
authors: R
authors: Takemoto
authors: Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York.
authors: Mathew
authors: M
authors: Hamula
authors: Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York.
authors: Patrick A
authors: PA
authors: Meere
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D001182:Arthroscopy; D003646:Debridement; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007592:Joint Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000473:pathology / Q000601:surgery; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D052256:Tendinopathy / Q000209:etiology / Q000473:pathology / Q000601:surgery
keywords: arthroscopy; fibrosis; patella clunk; posterior stabilized; revision total knee arthroplasty; total knee arthroplasty