Volume 3, Issue 1, Pages (March 2017)

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Volume 3, Issue 1, Pages 25-28 (March 2017) Total knee arthroplasty for treatment of osteoarthritis with prolonged patellar dislocation Kosuke Kumagai, MD, PhD, Mitsuhiko Kubo, MD, PhD, Tsutomu Maeda, MD, PhD, Susumu Araki, MD, PhD, Suguru Shioji, MD, Noriaki Okumura, MD, PhD, Hitomi Fujikawa, MD, Taku Kawasaki, MD, PhD, Shinji Imai, MD, PhD, Yoshitaka Matsusue, MD, PhD Arthroplasty Today Volume 3, Issue 1, Pages 25-28 (March 2017) DOI: 10.1016/j.artd.2016.10.001 Copyright © 2016 The Authors Terms and Conditions

Figure 1 Preoperative plain radiographs. (a) Anteroposterior view demonstrating severe OA with lateral dislocation of the patella. (b) Lateral view of the right knee. (c) Skyline radiographs showing that the patella is dislocated laterally on the edge of the lateral femoral condyle. Absence of the femoral sulcus is evident. Arthroplasty Today 2017 3, 25-28DOI: (10.1016/j.artd.2016.10.001) Copyright © 2016 The Authors Terms and Conditions

Figure 2 Preoperative computed tomography (CT) of the right knee. (a) Axial view. (b) Coronal view. (c, d) 3D-CT (multiplanar reconstruction). Arthroplasty Today 2017 3, 25-28DOI: (10.1016/j.artd.2016.10.001) Copyright © 2016 The Authors Terms and Conditions

Figure 3 Diagrams showing the multiple skin incisions used in the surgery. (a) A 20-cm longitudinal incision was made over the patella 1 cm laterally from the center of the patella. (b) The medial parapatellar approach was used. (c, d) Detachment of the lateral patellar retinaculum was performed from an extra-articular position via the outside of the subcutis. At that time, we retained the lower joint capsule and separated it with a lateral margin as much as possible. This approach was similar to that used in Z-plasty. Arthroplasty Today 2017 3, 25-28DOI: (10.1016/j.artd.2016.10.001) Copyright © 2016 The Authors Terms and Conditions

Figure 4 Postoperative plain radiograph. (a) Anteroposterior view. (b) Lateral view. (c) Skyline view. (d) Anteroposterior view of the whole length of the lower limbs. Arthroplasty Today 2017 3, 25-28DOI: (10.1016/j.artd.2016.10.001) Copyright © 2016 The Authors Terms and Conditions