A syndrome of patellofemoral dysfunction, consisting of painful popping,
catching, grinding, or jumping of the patellar component, can complicate
total knee replacement. From October 1983 to March 1988, eleven of 635
total knee replacements had this syndrome. On arthroscopic evaluation, the
dysfunction of the patellofemoral articulation was found to be secondary to
intra-articular fibrous bands. In eight patients, a transverse fibrous band
prevented the patella from seating well in the sulcus of the femoral
component. In four patients, the fibrous band extended from the
superolateral border of the patella to the infrapatellar fat pad, tethering
the patella laterally. In one patient, the fibrous band extended from the
distal pole of the patella to the intracondylar notch, tethering the
patella inferiorly. In all patients, the symptoms resolved after
arthroscopic removal of the fibrous bands.