Arthroscopic treatment of patellar clunk

Excellent results have been reported with posterior stabilized total knee a rthroplasty, A common complication relating to patellofemoral articulation is patellar clunk syndrome, Patellar clunk syndrome occurs when a fibrous n odule develops just proximal to the patellar button. At approximately 30 de grees to 45 degrees from full extension, the nodule catches the anterior fl ange of the femoral prosthesis, resulting in the clunk and a painful range of motion, The present study examines the use of arthroscopic debridement f or this disorder, Thirty consecutive patients (32 knees) with the diagnosis of patellar clunk syndrome were evaluated at 1 year after arthroscopic deb ridement, All patients were evaluated clinically and radiographically accor ding to the Knee Society score, In addition, patients mere questioned speci fically regarding anterior knee pain and patellofemoral symptoms, Radiograp hs were evaluated further regarding patella and component position, Patient s mere diagnosed with patellar clunk at an average of 12 months after their latest knee arthroplasty, with a range of 3 to 47 months, All patients com plained of anterior knee pain and the clunk, All patients had a hypertrophi c nodule at the junction of the proximal pole of the patella and quadriceps tendon and underwent arthroscopic debridement through a superolateral port al, All patients were free of patellar clunk postoperatively; one patient r eported persistent anterior knee pain. Knee Society scores increased from a n average of 64 points preoperative to 93 points postoperative. Radiographs showed patella alta in eight knees, patella baja in two, Four femoral comp onents were in 5 degrees flexion, The present study represents the largest collection of data regarding patellar clunk syndrome. The data appear to su pport arthroscopic debridement as a successful treatment of patellar clunk syndrome.