Ablation of a Patellar Button by Arthroscopy

Abstract

Fracture of the patella after total knee arthroplasty is an infrequent complication. In the presence of poor remaining bone stock, avascular necrosis, removal of the implant with partial or complete patellectomy is recommended. Arthroscopic removal of a loose body or cement extrusion has been recently attempted successfully in very few cases, where loose and mobile cement fragments were involved and were often removed piecemeal. The authors experienced an unusual case of a patient a 69-year-old woman who, after having fallen down, presented a comminuted patellar fracture. We recommended an external orthosis and a temporary limitation of activity. Four months later, the patient complained. An X-ray revealed a necrosis of the proximal fragment and a lowering of the patellar button with the distal bone fragment. The removal of the patellar button was performed by arthroscopy. Conservative treatment can be successful for this patients and the removal of the patellar button loosening via arthroscopy appears to be an attractive technique to be used in similar cases.

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Alidou, T. , Christophe, M. , Leopoldo, K. , Daouda, S. , Slim, M. , Rebecca, B. , Aimé, N. and Jean-Emile, D. (2015) Ablation of a Patellar Button by Arthroscopy. Open Journal of Orthopedics, 5, 345-349. doi: 10.4236/ojo.2015.511046.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Ortiguera, C.J. and Berry, D.J. (2002) Patellar Fracture after Total Knee Arthroplasty. Journal of Bone and Joint Surgery, 84A, 532-539.
[2] King, A.H., Engasser, W.M., Sousa, P.L., et al. (2015) Patellar Fracture Following Patellofemoral Arthroplasty. The Journal of Arthroplasty, 30, 1203-1206.
http://dx.doi.org/10.1016/j.arth.2015.02.007
[3] Dalury, D.F. and Adams, M.J. (2012) Minimum 6-Year Follow-Up of Revision Total Knee Arthroplasty without Patella Reimplantation. The Journal of Arthroplasty, 27, 91-94.
http://dx.doi.org/10.1016/j.arth.2012.04.012
[4] Lonner, J.H., Mont, M.A., Sharkey, P.F., et al. (2003) Fate of the Unrevised All-Polyethylene Patellar Component in Revision Total Knee Arthroplasty. Journal of Bone and Joint Surgery, 85A, 56.
[5] Francke, E.I. and Lachiewicz, P.F. (2000) Failure of a Cemented All-Polyethylene Patellar Component of a Press-Fit Condylar Total Knee Arthroplasty. Journal of Arthroplasty, 5, 234-237.
http://dx.doi.org/10.1016/S0883-5403(00)90396-6
[6] Meneghini, R.M. (2008) Should the Patella Be Resurfaced in Primary Total Knee Arthroplasty? An Evidence-Based Analysis. Journal of Arthroplasty, 23, 11-14.
http://dx.doi.org/10.1016/j.arth.2008.06.009
[7] Koh, Y.G., Kim, S.J., Chun, Y.M., et al. (2008) Arthroscopic Treatment of Patellofemoral Soft Tissue Impingement after Posterior Stabilized Total Knee Arthroplasty. The Knee, 5, 36-39.
http://dx.doi.org/10.1016/j.knee.2007.08.009
[8] Howe, D.J., Taunton Jr., O.D. and Engh, G.A. (2004) Retained Cement after Unicondylar Knee Arthroplasty: A Report of Four Cases. Journal of Bone and Joint Surgery, 86A, 2283.
[9] Kwang, A.J., Su, C.L. and Moon, B.S. (2008) Lateral Meniscus and Lateral Femoral Condyle Cartilage Injury by Retained Cement after Medial Unicondylar Knee Arthroplasty. Journal of Arthroplasty, 23, 1086-1089.
http://dx.doi.org/10.1016/j.arth.2007.09.025
[10] Melloni, P., Veintemillas, M., Marin, A., et al. (2008) Imaging Patellar Complications after Knee Arthroplasty. European Journal of Radiology, 65, 478-482.
http://dx.doi.org/10.1016/j.ejrad.2007.04.018
[11] Karataglis, D., Agathangelidis, F., Papadopoulos, P., et al. (2012) Arthroscopic Removal of Impinging Cement after Unicompartmental Knee Arthroplasty. Hippokratia, 16, 76-79.
[12] Hauptmann, M., Weber, P., Glaser, C., et al. (2008) Free Bone Cement Fragments after Minimally Invasive Unicompartmental Knee Arthroplasty: An Underappreciated Problem. Knee Surgery, Sports Traumatology, Arthroscopy, 16, 770-775.
http://dx.doi.org/10.1007/s00167-008-0563-5
[13] Kim, W.Y., Shafi, M., Kim, Y.Y., et al. (2006) Postero-medial Compartment Cement Extrusion after Unicompartmental Knee Arthroplasty Treated by Arthroscopy: A Case Report. Knee Surgery, Sports Traumatology, Arthroscopy, 14, 46-49.
http://dx.doi.org/10.1007/s00167-005-0627-8

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