Patellar Morphology and Femoral Component Geometry Influence Patellofemoral Contact Stress in Total Knee Arthroplasty Without Patellar Resurfacing

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2011 Nov 17

PMID 22086222

Citations 14

Authors

Atsushi Takahashi

Hirotaka Sano

Masahiro Ohnuma

Mitsuhiro Kashiwaba

Daisuke Chiba

Masayuki Kamimura

Takehiko Sugita

Eiji Itoi

Affiliations

Soon will be listed here.

Abstract

Purpose: The objective of this study was to determine the effect of patellar morphology and implant design on patellofemoral contact stress in total knee arthroplasty (TKA) without patellar resurfacing.

Methods: Radiographic investigation: One hundred and fifty-seven knees of 127 patients were included in the study. Implants used in the present series were Low Contact Stress (LCS), Genesis II and NexGen. The relationship between the pre-operative patellar facet angle and newly identified post-operative osteosclerosis was assessed. Finite element analysis: Using patient-specific patellar three-dimensional finite element models, the relationship between the patellar facet angle and mean von Mises stress within the patella was calculated at flexion angles of 15°, 45°, 75° and 105°.

Results: Radiographic investigation: Post-operative osteosclerosis was observed with decreasing patellar facet angle in the Genesis II (odds ratio = 0.72; 95% confidence interval, 0.55-0.93; P = 0.012) and NexGen implants (odds ratio = 0.87; 95% confidence interval, 0.77-0.99; P = 0.029). Patients treated with the Genesis II had significantly more advanced osteosclerosis than those treated with the other two implants. Finite element analysis: A negative correlation was found between the patellar facet angle and the mean von Mises stress for all three implants. The Genesis II showed significantly higher von Mises stress than the other two implants at flexion angles of 15°, 45° and 105°.

Conclusions: Both patellar morphology and femoral component geometry influence patellofemoral contact stress in total knee arthroplasty without patellar resurfacing.

Level Of Evidence: Case control study, Level III.

Citing Articles

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The effect of femoral prosthesis design on patellofemoral contact stresses in total knee arthroplasty: a case-control study with mid-term follow-up minimum 3-year follow-up.

Kong L, Lin W, Kang H, Li M, Hao K, Chang B J Orthop Surg Res. 2023; 18(1):781.

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Factors that impact the patellofemoral contact stress in the TKA: a review.

Yu Z, Cai H, Liu Z Arthroplasty. 2023; 5(1):44.

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Patellar Tracking in Total Knee Arthroplasty-Influence on Clinical and Functional Outcome.

Dahlmann S, Ziegeler K, Mau-Moller A, Mittelmeier W, Bergschmidt P Diagnostics (Basel). 2022; 12(5).

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[Biomechanical research on effects of pseudo-patella baja on stress of patellofemoral joint after total knee arthroplasty].

Wei W, Nie Y, Wu Y, Shen B Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021; 35(7):841-846.

PMID: 34308591 PMC: 8311199. DOI: 10.7507/1002-1892.202101166.

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