How is patellar maltracking corrected during total knee arthroplasty?

• A. Proper component rotation and soft tissue balancing, with possible lateral release or patellar resurfacing
• B. Increasing patellar tendon tension only
• C. Removing the patella
• D. Patellar tracking cannot be corrected surgically

Answer: (A)

Correcting patellar maltracking relies on optimizing patellofemoral biomechanics through component placement and soft tissue balance. The most effective approach is to ensure the femoral component is rotated correctly so the trochlear groove aligns with the patella, and to balance the soft tissues so the patella tracks centrally through the range of motion. If the lateral structures are tight and pull the patella laterally, a controlled lateral release can relieve that pull and allow the patella to glide within the groove. If necessary, patellar resurfacing can improve the articulation and tracking by providing a more congruent surface for the patella to ride on. Simply increasing patellar tendon tension isn’t a correct strategy and can worsen maltracking or cause stiffness. Removing the patella is not a standard corrective measure in this context.