Patella Medialization

Using a one-eighth-inch drill, the middle of the highest portion of the sagittal ridge of the patella is drilled perpendicular to the articular surface to a depth of approximately 12 mm. A patellar osteotomy is then made at the osteochondral junction, removing 7 mm of bone. The previously drilled hole is then identified, and used as the landmark for centering the patellar implant. This acts as a guide for proper medialization of the patella. The patellar sizer is then used to identify the correct size of patellar component that can be centered over the drill hole to reproduce the position of the patient's original high point, and allow a continuous rim of bone around the implant (Fig. 7.5). Eccentric placement of the patella 3 to 4 mm toward the medial facet utilizing this technique allows for better tracking and improved clinical results as discussed previously.

Median Ridge Patella

FIGURE 7.5. (A) Preoperative radiograph illustrating medial position of sagittal ridge of patella. (B) Drilling at the midpoint of sagittal ridge to mark the patella for medialization of the component. (C) Centering patellar reamer over the drill mark. (D) Postoperative radiograph of a medialized patellar component.

FIGURE 7.5. (A) Preoperative radiograph illustrating medial position of sagittal ridge of patella. (B) Drilling at the midpoint of sagittal ridge to mark the patella for medialization of the component. (C) Centering patellar reamer over the drill mark. (D) Postoperative radiograph of a medialized patellar component.

Patellar Component
Figure 7.5. Continued.
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