Anterior Knee Pain Due to Biplanar Rotatory Malalignment of the Femoral Component in Total Knee Arthroplasty Case Report

摘要

Total knee arthroplasty (TKA) is successful, with >90% survivorship at 10-13 years.28'32'34 Despite improvements in design and technique, clinical failures occur at a rate of 0.5%-1% annually.29'34 Anterior knee pain after TKA is common, occurring in 5%-1.5% of patients,4 and can be caused by infection, patellofemoral complications,7'8'18'33'35 stress fractures,31 and aseptic loosening. Some patients experience pain despite a well-functioning arthroplasty and satisfactory range of motion. The incidence of pain for which no obvious explanation has been reported as 1 in 300 arthroplasties.20 Although the cause usually is difficult to demonstrate, various possibilities include reflex sympathetic dystrophy,22 metal allergy, low-grade subclinical infection, or interposed meniscal fragment.This article presents three patients in whom an otherwise satisfactory TKA caused persistent, point-specific, anterolateral knee pain due to biplanar rotatory malalignment of the femoral component.