title: Patellar malalignment treatment in total knee arthroplasty.
abstract: The patella, with or without resurfacing, plays a fundamental role in the success of a total knee arthroplasty (TKA). Patellofemoral joint complications are due to problems related to the patient, to the surgical technique, or to the design of the components. Patellar tracking is influenced by several factors: a severe preoperative valgus, the presence of pre-existing patellofemoral dysplasia, the design of the femoral component, the surgical approach, the Q angle, the mechanical alignment of the limb, the tightness of the lateral retinaculum, the positioning of the patellar component in the proximal-distal and medial-lateral directions, the patella height, the patella (native or resurfaced) thickness, the size of the femoral and the tibial components, and the alignment and rotation of the components. Several factors are crucial to prevent patellar maltracking in TKA: the use of an anatomical femoral component, a meticulous surgical technique, careful dynamic intraoperative assessment of patellar tracking, and, if necessary, the achievement of an adequate lateral release.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University of Catanzaro, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gasparini
authors.affiliation: Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University of Catanzaro, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Familiari
authors.affiliation: Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University of Catanzaro, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ranuccio
keywords: alignment; patellofemoral joint; total knee arthroplasty