surgical technique

Patella Resurfacing



1. Always resurface

2. Never resurface

3. Selectively resurface


Decision Making



- literature divided on issue



- poor outcomes due to poor implant design

- now improved designs

- non resurfacing also improved due to better design and improved techniques in regard to tracking and rotation


Oxford Technique

PreoperativeUKA Oxford AP



- anteromedial disease

- patient points to anterior medial joint line only as source of pain


Pre-op x-rays

- AP and lateral

- Rosenberg to assess lateral joint

- long leg AP view to assess alignment


Pre-op examination

Quadriceps Rupture



Usually occurs in patients over 60

- due to decreased vascularity & collagen weakness


Younger patient on steroids / growth hormone


Occasionally occurs in young athlete with excessive contracture




Often preceded by quadriceps tendinosis


Tibial Plateau


Schatzker Classification


I.  Lateral Spilt 

- seen in young patient

- lateral meniscus can be incarcerated in fracture


Tibial Plateau Schatzker 1


II.  Lateral Split Depression

- often seen in young patients with high energy injuries

- vary in severity