Transillumination method in total knee arthroplasty: new approach with old tools.

Blood supply Lateral retinaculum release Patella Total knee arthroplasty

Journal

International orthopaedics

ISSN: 1432-5195

Titre abrégé: Int Orthop

Pays: Germany

ID NLM: 7705431

Informations de publication

Date de publication:
13 Sep 2023

Historique:

received: 19 07 2023

accepted: 05 09 2023

medline: 13 9 2023

pubmed: 13 9 2023

entrez: 12 9 2023

Statut: aheadofprint

Résumé

In this study, we evaluated the possibility of precise intraoperative localization of the lateral genicular arteries by an orthopaedic surgeon using the transillumination method. Twelve patients underwent cemented TKA with patella-friendly Zimmer Biomet NexGen Legacy Posterior Stabilized prostheses (without patellar resurfacing), seven right knees and five left knees. The mean age of patients in the study group was 66.636 ± 7.003 years. The minimal follow-up period was 13 months (mean-16.363 ± 2.5 months). Functional outcomes were assessed using Knee Society and a specific patellar questionnaire-Kujala Score. Intraoperative detection of insufficient patellar stability and/or patellar maltracking was based on the no-thumb technique. In pre- and postoperative period X-ray investigation, standard standing X-ray and Merchant view were used to evaluate implant position and patellofemoral congruency. In this study, ten out of twelve knee joints (83.3%) had at least one artery visible by the proposed method in the lateral parapatellar area. Five out of ten knee joints had more than one artery that could be visualized and identified as an arterial vessel. Postoperative Knee Society Score showed significant improvement from a mean 51.181 ± 3.868 to a mean 88.727 ± 3.663. Mean hospital length of stay is 8.545 ± 1.863 days. X-ray assessment using standard anteroposterior, lateral, and Merchant skyline views showed appropriate implant positioning and patellofemoral congruency. The mean Kujala Score in the postoperative period (3 and 6 months) was 67.3 ± 6.75 and 75.6 ± 6.42, respectively. Using the proposed transillumination method can help preserve the lateral blood supply to the patella and to avoid devascularized patella-related complications. Retrospectively registered on 5 of May 2023, Registration number - 3/3-1757.

Identifiants

DOI: 10.1007/s00264-023-05977-6 PMID: 37700200

pubmed: 37700200

doi: 10.1007/s00264-023-05977-6

pii: 10.1007/s00264-023-05977-6

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

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