Abstract

NEVES, Pedro; SOARES, Daniel; COSTA, Luís  and  SOUSA, Ricardo. Artroplastia total do joelho em doente previamente patelectomizado: reconstrução patelar com técnica original utilizando autoenxerto de prato tibial. Rev. Port. Ortop. Traum. [online]. 2018, vol.26, n.1, pp.67-74. ISSN 1646-2122.

Introduction: the authors aim to demonstrate an original technique for patellar reconstruction, presenting a clinical case. It’s a patient previously patellectomized for patelofemoral osteoarthritis, with progressive symptomatic femorotibial compartment osteoarthritis in the ipsilateral knee. Given the decreased extensor strength of extensor apparatus of the knee, we considered it would be important to reconstruct the patella at the time of arthroplasty Case Presentation: in this paper, we present patient functional status, including pre- and post-operative range of motion and functional scores. We describe in detail all the steps constituting the surgical procedure, including graft harvesting, the graft adjustment to size and shape needed and how it was integrated in a subsynovial pouch. Discussion-Conclusion: patellectomy should not exclude a patient from a total knee arthroplasty, not only for the possible good results, but also for the diversity of surgical techniques for patella reconstruction. Despite the good results with recognized techniques, all of them have some disadvantages. The use of external tibial plateau seems to be an excellent option, with minimum morbidity and, beyond the immediate good results, demonstrated mid-term clinical advantages.

Keywords : Patellectomy; patella; reconstruction; knee; arthroplasty.

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