Retrospective review of 211 primary TKAs asking which patients and which patellar implants are at greatest risk for patellofemoral complications. It correlates complication rates with implant design, fixation method, and patient risk factors.
When resurfacing the patella in TKA, the implant choice that minimizes complications is a cemented all-polyethylene dome. This series gives it a 2.4% complication rate.
Metal-backed patellar components are the trap to avoid. The metal base forces a thin polyethylene layer that wears and dissociates, then sheds debris that damages the femoral and tibial surfaces. A failed metal-backed patella can convert an isolated revision into a full three-compartment revision.
Fixation matters as much as design. Cementless patellar loosening ran 13.5% vs 1.2% cemented, so cement the patella. Watch your high-risk patients: obesity drives both complications and loosening, and a lateral retinacular release can devascularize the patella and precipitate fracture. If you must release, be aware of the vascular trade-off.
Retrospective review of 211 primary TKAs asking which patients and which patellar implants are at greatest risk for patellofemoral complications. It correlates complication rates with implant design, fixation method, and patient risk factors.
When resurfacing the patella in TKA, the implant choice that minimizes complications is a cemented all-polyethylene dome. This series gives it a 2.4% complication rate.
Metal-backed patellar components are the trap to avoid. The metal base forces a thin polyethylene layer that wears and dissociates, then sheds debris that damages the femoral and tibial surfaces. A failed metal-backed patella can convert an isolated revision into a full three-compartment revision.
Fixation matters as much as design. Cementless patellar loosening ran 13.5% vs 1.2% cemented, so cement the patella. Watch your high-risk patients: obesity drives both complications and loosening, and a lateral retinacular release can devascularize the patella and precipitate fracture. If you must release, be aware of the vascular trade-off.