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Non-patellar problems may be the cause of post-TKA anterior knee pain
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PARK CITY, Utah — Anterior knee pain is common after total knee arthroplasty and, despite the inclination to attribute it a resurfaced or unresurfaced patella, a presenter at the Joint Arthroplasty Mountain Meeting said an underlying problem is more likely the cause.
“I think anterior knee pain is an issue whether or not you resurface the patella,” Robert L. Barrack, MD, said. Anterior knee pain after TKA is a problem Barrack says he sees.
He resurfaces few patellae, but said he sees this type of pain more often in the resurfaced patella.
Barrack suggested that surgeons find the location of the pain, which is frequently superolateral, and determine whether it occurs consistently with certain activities, such as using the stairs and moving into and out of a sitting position.
“It is usually not the patella. It is something wrong in the knee: subtle malrotation, malalignment, instability. Occasionally, you can just resurface the patella, but think about changing the liner, making it more stable,” Barrack said.
During his presentation and the audience discussion period, comments were made about the use and appropriateness of CT scans to better diagnose the problem. In addition, Barrack discussed facetectomy and denervation of the knee cartilage with a bovie to resolve this type of pain.
“An option is injection, if it’s provocative pain,” he said. – by Susan M. Rapp
Reference:
Barrack RL. Anterior knee pain with unresurfaced patella. Presented at: Joint Arthroplasty Mountain Meeting; Feb. 10-13, 2019; Park City, Utah.
Disclosure: Barrack reports no relevant financial disclosures.