Hidenori Tanikawa1, Mitsunori Tada2, Kengo Harato3, Kazunari Okuma1, Takeo Nagura4. 1. Department of Orthopaedic Surgery, Saitama City Hospital, Saitama-shi, Saitama-ken, Japan. 2. Digital Human Research Centre, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan. 3. Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan. 4. Department of Clinical Biomechanics, Keio University School of Medicine, Tokyo, Japan.
Abstract
BACKGROUND: Patellofemoral complications are one of the main problems after total knee arthroplasty (TKA). The design of the TKA component may affect the patellar biomechanics, which may be associated with this postoperative complication. The purpose of this study was to assess the influence of TKA and prosthesis designs on the patellar kinematics and patellofemoral pressure. METHODS: Using fresh-frozen cadavers, we measured the patellofemoral pressure, patella offset, and patella tilt in the following 4 conditions: normal knee (patella replacement only), cruciate-retaining TKA, condylar-stabilizing TKA, and posterior-stabilized TKA. RESULTS: The patellofemoral pressure increased significantly after the cruciate-retaining TKA and condylar-stabilizing TKA compared with the normal knee. The patella offset in the normal knee decreased with increasing knee flexion angles, while the patella offset in the TKA knees did not change significantly through the full range of motion. The amount of lateral patella tilt in the normal knee was significantly larger than the TKA knees in the full range of motion. CONCLUSION: Although the femoral components are designed to reproduce an anatomical patellar tracking, the physiological patellar kinematics were not observed. Relatively high patellofemoral pressure and kinematic change after TKA may be associated with postoperative complications such as the anterior knee pain.
BACKGROUND: Patellofemoral complications are one of the main problems after total knee arthroplasty (TKA). The design of the TKA component may affect the patellar biomechanics, which may be associated with this postoperative complication. The purpose of this study was to assess the influence of TKA and prosthesis designs on the patellar kinematics and patellofemoral pressure. METHODS: Using fresh-frozen cadavers, we measured the patellofemoral pressure, patella offset, and patella tilt in the following 4 conditions: normal knee (patella replacement only), cruciate-retaining TKA, condylar-stabilizing TKA, and posterior-stabilized TKA. RESULTS: The patellofemoral pressure increased significantly after the cruciate-retaining TKA and condylar-stabilizing TKA compared with the normal knee. The patella offset in the normal knee decreased with increasing knee flexion angles, while the patella offset in the TKA knees did not change significantly through the full range of motion. The amount of lateral patella tilt in the normal knee was significantly larger than the TKA knees in the full range of motion. CONCLUSION: Although the femoral components are designed to reproduce an anatomical patellar tracking, the physiological patellar kinematics were not observed. Relatively high patellofemoral pressure and kinematic change after TKA may be associated with postoperative complications such as the anterior knee pain.
Authors: Benjamin Kerzner; Mario Hevesi; Luc M Fortier; Monique S Haynes; Safa Gursoy; Suhas P Dasari; Zeeshan A Khan; Adam B Yanke; Jorge Chahla Journal: Arthrosc Tech Date: 2022-05-21
Authors: In Jun Koh; Il Jung Park; Charles C Lin; Nilay A Patel; Christen E Chalmers; Mauro Maniglio; Michelle H McGarry; Thay Q Lee Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-10-28 Impact factor: 4.342