The Journal of Arthroplasty
Volume 25, Issue 2 , Pages 249-253, February 2010

Gull-Wing Osteotomy for the Treatment of the Deficient Patella in Revision Total Knee Arthroplasty

  • Gregg R. Klein, MD

      Affiliations

    • Hartzband Center for Hip and Knee Replacement, Paramus, New Jersey
    • Hackensack University Medical Center, Hackensack, New Jersey
    • Corresponding Author InformationReprint requests: Gregg R. Klein, MD, Hartzband Center for Hip and Knee Replacement, 10 Forest Avenue, Paramus, NJ 07652.
    • ,
  • Harlan B. Levine, MD

      Affiliations

    • Hartzband Center for Hip and Knee Replacement, Paramus, New Jersey
    • Hackensack University Medical Center, Hackensack, New Jersey
    • ,
  • John F. Ambrose, MD

      Affiliations

    • St. Joseph's Medical Center, Paterson, New Jersey
    • ,
  • Helena C. Lamothe, BS

      Affiliations

    • Hartzband Center for Hip and Knee Replacement, Paramus, New Jersey
    • Hackensack University Medical Center, Hackensack, New Jersey
    • ,
  • Mark A. Hartzband, MD

      Affiliations

    • Hartzband Center for Hip and Knee Replacement, Paramus, New Jersey
    • Hackensack University Medical Center, Hackensack, New Jersey

Received 6 September 2008; accepted 1 January 2009. published online 05 February 2009.

Abstract 

Reconstruction of the deficient patella remains a challenge in revision total knee arthroplasty. Twelve consecutive patients who had a knee revision in which a nonresurfacable patella was treated with a gull-wing patellar osteotomy were followed using a computerized database. Radiographs revealed successful healing of the osteotomy in all patients with central tracking of the patella in the trochlear groove. There was a significant improvement in the range of motion and Knee Society scores. There were no patellar fractures or significant patellar malalignment in this series. This technique has shown promising results for the treatment of the nonresurfacable patella during revision total knee arthroplasty, and we conclude that it is a viable method of patellar salvage reserved for the most advanced cases of patellar bone stock compromise.

Keywords: revision knee arthroplasty, patella, gull-wing osteotomy, salvage, extensor mechanism

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 No benefits or funds were received in support of the study.

PII: S0883-5403(09)00006-0

doi:10.1016/j.arth.2009.01.002

The Journal of Arthroplasty
Volume 25, Issue 2 , Pages 249-253, February 2010

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