Our Summary

This research paper discusses the issues that can arise from a condition called patella baja (a lower than normal kneecap) in patients who have had total knee replacement surgery. This condition can be caused by previous knee surgeries and can be diagnosed using specific measurements of kneecap height. It’s crucial to distinguish between true patella baja and a similar but different condition, pseudopatella baja, by using kneecap height ratios. Treating patella baja involves figuring out what caused it and then managing it appropriately. Different surgical techniques can be used to manage this condition, including moving the bony bump on the shinbone (tibial tubercle osteotomy), adjusting the femur or knee replacement components, or making a specific type of cut and suture in the kneecap tendon (Z-plasty). The paper reviews the results of each of these surgical techniques.

FAQs

  1. What is Patella baja in total knee arthroplasty and what are its effects?
  2. How is Patella baja diagnosed in total knee arthroplasty?
  3. What are the possible treatment options for Patella baja in total knee arthroplasty?

Doctor’s Tip

A doctor may advise a patient undergoing knee replacement surgery to follow post-operative rehabilitation exercises to improve range of motion and prevent complications such as patella baja. It is important to follow the rehabilitation plan provided by the healthcare team to ensure optimal recovery and function of the knee joint.

Suitable For

Patients who are typically recommended for knee replacement surgery include those who have severe knee pain that limits their daily activities, stiffness in the knee that makes it difficult to bend or straighten the leg, chronic inflammation or swelling that does not improve with rest or medications, and knee deformities such as bowing in or out of the knee. Other factors that may indicate the need for knee replacement surgery include failure of previous non-surgical treatments such as physical therapy, medications, or injections, and a significant decrease in quality of life due to knee pain and limitations. Additionally, patients with patella baja in total knee arthroplasty may also be recommended for knee replacement surgery if they are experiencing impingement, pain, and decreased range of motion as a result of this condition.

Timeline

Before knee replacement surgery, a patient typically experiences chronic knee pain, stiffness, swelling, and limited range of motion. They may have tried conservative treatments such as physical therapy, pain medications, and injections with little to no relief. As their condition worsens, they may have difficulty performing daily activities and experience a decreased quality of life.

After knee replacement surgery, the patient undergoes a period of rehabilitation and physical therapy to regain strength, flexibility, and range of motion in the knee. They may experience some pain and discomfort initially, but this typically improves over time as the knee heals. The patient gradually resumes normal activities and experiences improved mobility and function in the replaced knee. In the long term, the patient can expect reduced pain, improved quality of life, and increased mobility and independence.

What to Ask Your Doctor

Some questions a patient should ask their doctor about knee replacement include:

  1. What is the reason for my knee pain and why is a knee replacement necessary?
  2. What are the risks and potential complications of knee replacement surgery?
  3. What type of knee replacement procedure will be performed and why is this the best option for me?
  4. How long is the recovery process and what can I expect in terms of pain management and physical therapy?
  5. What are the expected outcomes of the surgery in terms of pain relief, range of motion, and overall function?
  6. Are there any specific restrictions or activities I should avoid after knee replacement surgery?
  7. How long will the knee replacement last and are there any potential long-term issues I should be aware of?
  8. What are my options if I experience any complications or dissatisfaction with the results of the knee replacement surgery?
  9. How often will I need follow-up appointments and monitoring after the surgery?
  10. Are there any lifestyle changes or modifications I should consider to ensure the success of the knee replacement surgery?

Reference

Authors: Lum ZC, Saiz AM, Pereira GC, Meehan JP. Journal: J Am Acad Orthop Surg. 2020 Apr 15;28(8):316-323. doi: 10.5435/JAAOS-D-19-00422. PMID: 31934927