New treatment of patellar instability after total knee arthroplasty: A case report and review of literature

doi:10.12998/wjcc.v8.i21.5487

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Nov 6, 2020; 8(21): 5487-5493
Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5487

New treatment of patellar instability after total knee arthroplasty: A case report and review of literature

Xian-Yue Shen, Jian-Lin Zuo, Jian-Peng Gao, Tong Liu, Jian-Lin Xiao, Yan-Guo Qin

Xian-Yue Shen, Jian-Lin Zuo, Jian-Peng Gao, Tong Liu, Jian-Lin Xiao, Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China

Xian-Yue Shen, Yan-Guo Qin, Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China

Author contributions: Shen XY, Gao JP, Xiao JL, and Zuo JL were the clinicians involved in patient diagnostics, management, therapy, and follow-up; Shen XY reviewed the literature and wrote the draft; Qin YG and Xiao JL contributed to reviewing the literature and manuscript drafting; Xiao JL and Zuo JL analyzed and interpreted the imaging findings; Xiao JL and Qin YG was responsible for the critical revision of the manuscript for relevant intellectual content; All of the authors approved the final version of the paper prior to submission.

Informed consent statement: The patient consented to the publication of this study.

Conflict-of-interest statement: The authors declare no conflicts of interest.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Jian-Lin Xiao, MD, PhD, Chief Doctor, Postdoc, Department of Orthopaedics, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun 130033, Jilin Province, China. xiaojianlin10@jlu.edu.cn

Received: June 4, 2020
Peer-review started: June 11, 2020
First decision: September 13, 2020
Revised: September 19, 2020
Accepted: September 28, 2020
Article in press: September 28, 2020
Published online: November 6, 2020
Processing time: 147 Days and 23.1 Hours

Abstract

BACKGROUND

Patellar instability is an uncommon complication after total knee arthroplasty (TKA). Partial lateral patella facetectomy (LPF) with lateral retinaculum release treatment of patellar instability is rarely reported.

CASE SUMMARY

We present a case of patellar instability 8 mo after primary TKA. Treatment of this complication was adapted to address the cause of the dislocation. To eliminate patellar instability, we restored the vastus medialis and performed LPF with lateral retinaculum release. We achieved normal patellar tracking. Clinical and radiographic evaluations at the 1-year postoperative follow-up were satisfactory.

CONCLUSION

LPF with lateral retinaculum release represents a promising option to restore central patellar tracking in patients with patellar instability after TKA in cases without component malposition.

Keywords: Total knee arthroplasty; Patellar instability; Lateral patella facetectomy; Complication; Case report

Core Tip: Patellar instability is an uncommon complication after total knee arthroplasty (TKA). We report a case who had patellar instability 8 mo after primary TKA, and skyline view revealed a lateral shift of the patella. To eliminate patellar instability, we restored the vastus medialis and performed partial lateral patella facetectomy with lateral retinaculum release. This report is the first to describe successful treatment of patellar instability after TKA by lateral patella facetectomy with lateral retinaculum release. This procedure represents a promising option to restore central patellar tracking in patients with patellar instability after TKA.