Computer-Assisted Navigation in Patellofemoral Arthroplasty: a New Technique to Improve Rotational Position of the Trochlea

Philippe Hernigou, MD
Hospital Henri Mondor, Avenue du Marechal de Lattre de Tassigny, France

Charles Henri Flouzat-Lachaniette, MD
Hospital Henri Mondor, Avenue du Marechal de Lattre de Tassigny, France

William Delblond, MD
Hospital Henri Mondor, Avenue du Marechal de Lattre de Tassigny, France

Pascal Duffiet, MD
Hospital Henri Mondor, Avenue du Marechal de Lattre de Tassigny, France

Didier Julian, MD
Hospital Henri Mondor, Avenue du Marechal de Lattre de Tassigny, France


Abstract

Background

Maltracking or subluxation is one of the complications of patellofemoral arthroplasty.

Questions/Purposes

We questioned whether the computed navigation system can improve patellar tracking in patients with patellofemoral arthroplasty (PFA).

Methods

Between 2007 and 2010 we performed 15 patellofemoral arthroplasties using the Ceraver PFA and navigation assistance. Fifteen other patients underwent surgery without navigation during the same period and acted as a control group. The rotation of the native trochlea as measured using the epicondylar line as a reference before surgery and the rotation of the trochlear component and the trochlear twist angle were assessed with computed tomography (CT) scan after surgery.

Results

The mean follow-up was 3 years (range, 25 years). The group with navigation had no patellofemoral complications and better clinical scores. The group without navigation had abnormal patellofemoral tracking in 5 of the 15 patients. CT scan demonstrated excessive internal component rotation, as compared with patients without complications. This excessive internal rotation was proportional to the severity of the patellofemoral maltracking.

Conclusions

The short-term results suggest that navigation can lead to better trochlear rotation which, in our hands, is associated with fewer cases of patellar maltracking and better overall clinical scores.

This article appears in HSS Journal: Volume 9, Number 2.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.


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