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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 4, 463-468.
doi: 10.1302/0301-620X.91B4.21494  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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The incidence of the patellar clunk syndrome in a recently designed mobile-bearing posteriorly stabilised total knee replacement

K. Fukunaga, MD, Orthopaedic Surgeon1; A. Kobayashi, MD, PhD, Vice-Chairman2; Y. Minoda, MD, PhD, Lecturer1; H. Iwaki, MD, PhD, Lecturer1; Y. Hashimoto, MD, PhD, Assistant Professor1; and K. Takaoka, MD, PhD, Professor1

1 Department of Orthopaedic Surgery Osaka City University Medical School, 1-4-3 Asahi-machi Abeno-ku Osaka, 545-8585, Japan.
2 Department of Orthopaedic Surgery Osaka General Medical Center, 3-1-56 Mandai-higashi Sumiyoshi-ku, Osaka 558-8558, Japan.

Correspondence should be sent to Dr Y. Minoda; e-mail: yminoda{at}msic.med.osaka-cu.ac.jp

The patellar clunk syndrome describes painful catching, grinding or jumping of the patella when the knee moves from a flexed to an extended position after total knee replacement (TKR). The posterior stabilised TKR had been noted to have a higher incidence of this problem. Mobile-bearing posteriorly stabilised TKRs have been introduced to improve patellar tracking and related problems by a mechanism of self-alignment. We evaluated the patellar clunk syndrome in 113 knees in 93 patients with such a TKR at a mean follow-up of 2.3 years (2.0 to 3.2). The syndrome was identified in 15 knees (13.3%).

Logistic regression analysis showed that the absolute value of the post-operative angle of patellar tilt was significantly associated with the occurrence of patellar clunk (p = 0.025). Patellar tracking should be carefully checked during surgery.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General