Our Summary

Patella baja is a rare knee condition that causes stiffness and pain at the front of the knee, often occurring after injury, long periods of immobility or surgery. It involves the shortening and thickening of the patellar ligament (the tough band of tissue connecting the kneecap to the shinbone). Various surgical methods have been used to treat it, but there’s no standard treatment. This research paper discusses the case of a 73-year-old woman who had this condition following a total knee replacement. She was treated with a relatively new type of soft tissue surgery and saw significant improvement, with her knee’s function score going from 16 to 81. She was able to move her knee earlier than expected and return to her daily activities.

FAQs

  1. What is Patella baja and what causes it?
  2. What surgical methods have been used to treat Patella baja?
  3. What were the results of the z-plasty surgery on the 73-year-old woman with Patella baja?

Doctor’s Tip

A doctor might tell a patient about z-plasty that it is a surgical technique used to improve the appearance and function of scars, particularly in areas where there is tension or limited mobility. It involves creating Z-shaped incisions in the skin to redistribute tension and allow for better healing. Patients undergoing z-plasty should follow their doctor’s post-operative instructions carefully to ensure optimal healing and minimize the risk of complications.

Suitable For

Patients with patella baja or other conditions that involve scarring and contractures of the skin and underlying tissues are typically recommended for z-plasty surgery. Z-plasty is a surgical technique used to improve the function and appearance of scars by rearranging the skin in a zigzag pattern. This can help to release tension in the scar tissue, improve flexibility, and reduce pain and discomfort. Z-plasty is often used in cases where traditional scar revision techniques are not effective or where there is significant contracture or distortion of the skin.

Timeline

Before z-plasty:

  1. Patient experiences stiffness and pain at the front of the knee.
  2. Patient may have a history of injury, immobility, or previous surgery.
  3. Diagnosis of patella baja is confirmed through imaging studies and physical examination.
  4. Various conservative treatments such as physical therapy and pain medication may be attempted with limited success.
  5. Patient and healthcare provider discuss surgical options for treatment.

After z-plasty:

  1. Patient undergoes z-plasty surgery to lengthen and release the shortened patellar ligament.
  2. Surgery is successful in improving the range of motion and reducing pain in the knee.
  3. Patient undergoes post-operative rehabilitation to strengthen the knee and improve function.
  4. Patient experiences significant improvement in knee function, with a noticeable increase in the function score.
  5. Patient is able to return to daily activities earlier than expected and experiences a better quality of life.

What to Ask Your Doctor

  1. What is a z-plasty and how does it work to treat patella baja?
  2. What are the potential risks and complications associated with z-plasty surgery?
  3. How long is the recovery process after undergoing a z-plasty procedure?
  4. What are the expected outcomes and success rates for patients with patella baja treated with z-plasty?
  5. Are there any alternative treatment options for patella baja besides z-plasty?
  6. Will physical therapy be necessary after undergoing z-plasty surgery?
  7. How long will it take to see improvements in knee function after the z-plasty procedure?
  8. What can I do to optimize the success of the z-plasty surgery and my recovery process?
  9. Are there any long-term implications or considerations to keep in mind after undergoing z-plasty for patella baja?
  10. Are there any restrictions or limitations on activities I should be aware of following z-plasty surgery?

Reference

Authors: Costa TAAO, Bernardes F, Miradouro J, Pereira J, Barreira P, Carvalho J. Journal: Rev Bras Ortop (Sao Paulo). 2024 Apr 19;59(Suppl 1):e123-e126. doi: 10.1055/s-0043-1770967. eCollection 2024 Jul. PMID: 39027191