Table 3 Techniques and considerations to mitigate the risk of complications following PPR
Complication | Consideration/technique |
|---|---|
Patella fracture | Using all-polyethylene patella button Avoiding button with large central peg Avoiding excessive patella resection |
Patella avascular necrosis | Avoiding excessive lateral retinacular release Avoiding excessive patella reaming |
Patella clunk | Femoral component: low intercondylar box ratio Avoiding significant changes in joint line height, reduced patella thickness, using a small patella button Maintaining posterior condylar offset |
Under/overstuffing | Restoring native patella thickness Using appropriate size femoral component without anteriorisation |
Patella instability | Using femoral component with extended and deep trochlea groove Attention to internal rotation of femoral component Tibial component external rotation and centralisation Medialising and superiorisation of patella button Performing a lateral patella facetectomy if necessary |
Extensor mechanism disruption | Avoiding aggressive eversion of patella Avoid change of joint line height |