2 year postop
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Could not understand the cause of early patella loosening at 3 years post op. The surgical notes and video were reviewed to look for intra-op issues and found none. No history of falls. History of intensive physio and opposite foot surgey cannot clearly explain the cause.
Intraop, the patella appeared A concave thin shell 6 mm thick at its deepest point and 10mm thick at its thickest point at the edges.
Gull wing osteotomy, Trabecular metal patella augment, allograft are the options. we decided to go for Rebarr patellar technique as descibed using maxillofacial cortical screw as seen below and cemented a patella over it. at 3 months she is still good
McPherson EJ, Sherif SM, Dipane MV, Arshi A. Patellar Rebar Augmentation in Revision Total Knee Arthroplasty. J Arthroplasty. 2021 Feb;36(2):670-675. doi: 10.1016/j.arth.2020.08.057. Epub 2020 Sep 1. PMID: 32951925.
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