Systematic Reviews
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2020; 11(3): 184-196
Published online Mar 18, 2020. doi: 10.5312/wjo.v11.i3.184
Systematic review of the etiology behind patellar clunk syndrome
Sean Bertram Sequeira, James Scott, Wendy Novicoff, Quanjun Cui
Sean Bertram Sequeira, James Scott, Wendy Novicoff, Quanjun Cui, Department of Orthopedic Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, United States
Author contributions: Cui Q conceived the study idea and designed the research with Scott J; Sequeira SB wrote the manuscript and analyzed the data; Sequeira SB collected the data; Sequeira SB, Cui Q, Novicoff W, and Scott J edited and revised the manuscript.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Quanjun Cui, MD, G.J. Wang Professor of Orthopedic Surgery, Vice Chair for Research, Department of Orthopedic Surgery, University of Virginia School of Medicine, 400 Ray C Hunt Dr, Charlottesville, VA 22908, United States. qc4q@hscmail.mcc.virginia.edu
Received: September 28, 2019
Peer-review started: September 28, 2019
First decision: December 24, 2019
Revised: December 24, 2019
Accepted: January 19, 2020
Article in press: January 19, 2020
Published online: March 18, 2020
Processing time: 170 Days and 4.7 Hours
Core Tip

Core tip: Patellar clunk syndrome is the development of a fibrous nodule along the undersurface of the quadriceps tendon and proximal to the superior pole of the patella after a posterior-stabilized total knee arthroplasty. It can be diagnosed clinically by its namesake pathognomonic clunk when moving the knee from full flexion to extension with anterior knee pain or by radiograph, ultrasound, or magnetic resonance imaging. Ultimately, the etiology of patellar clunk syndrome is most dependent upon prosthesis design, which is largely dependent upon incorporate a reduced intercondylar box ratio and box width to reduce contact between the proximal patellar pole and the intercondylar box.