Lateral Release Can Increase Range of Flexion during
Computer Assisted Total Knee Arthroplasty with
Patellar Maltracking
Pornpavit Sriphirom MD*,
Chaiyaporn Siramanakul MD**, Boonyawat Chanopas MD***
Affiliation :
* Department of Orthopedic Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
** Department of Orthopedic Surgery, Banphaeo Hospital (Prommitr Branch), Bangkok, Thailand
*** Department of Orthopedic Surgery, Medical Development Clinic, Bangkok, Thailand
Objective : The patellar tracking is an important factor that affect range of motion after total knee arthroplasty (TKA).
Intraoperative patellar maltracking during TKA can be improved by performing lateral release. We hypothesized that TKA
with patellar maltracking after undergoing lateral release can increase intraoperative range of flexion.
Material and Method: A prospective study was conducted on 110 knees that underwent computer assisted TKA. The patellar
tracking was assessed with no thumb test technique. Fifty-two knees were classified into negative no thumb test group, and
58 knees were classified into positive no thumb test group. The positive no thumb test group further received lateral release
with outside to inside technique. The range of flexion was recorded before and after final implantation in both groups, and
recorded after lateral release in positive no thumb test group.
Results : After final implantation, the negative no thumb test group had significant greater flexion angle than the positive
no thumb test group (128.20° and 123.90°). The range of flexion after performing the lateral release in positive no thumb
test group increased the flexion up to 127.60°. Thus, there was no significant difference from the negative no thumb test
group (128.20°). After the lateral release was performed, the flexion angle had significantly increased by 3.70°.
Conclusion : The results indicated that intraoperative lateral release in patellar maltracking can improve range of flexion
in computer assisted TKA.
Keywords : Lateral release, Patellar maltracking, Computer assisted total knee arthroplasty
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