Patellar crepitus after total knee revision

摘要

INTRODUCTION: Patellofemoral complications after total knee replacement (TKR) have been reported to occur in up to 12% in primary TKR and up to 45% in revision TKR. Complications include anterior knee pain, subluxation, impingement, fracture, loosening and patellar crepitation. Patellar crepitation or clunk after TKR usually is caused by the formation of peripatellar scar tissue with an incidence up to 13% in recent reports, as shown in Table 1. This scar tissue is related to implant design, surgical technique and host factors, with microscopic and gross findings indicating varying degrees of inflammatory fibrous hyperplasia. Most patients with mildly painful or painless patellar crepitation will improve within 6 months to 1 year. In patients with more disabling symptoms, early intervention with arthroscopic or open scar excision should be considered. Patellar crepitation has been described after primary TKR but to our knowledge has not been reported after revision TKR. The authors have obtained the patient's informed written consent for print and electronic publication of the case report.