TKA Design-integrated Trochlea Groove Rotation Reduces Patellofemoral Pressure

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2018 Dec 20

PMID 30564858

Citations 8

Authors

Matthias Woiczinski

Manuel Kistler

Christian Schroder

Christian Braun

Patrick Weber

Peter E Muller

Volkmar Jansson

Arnd Steinbruck

Affiliations

Soon will be listed here.

Abstract

Purpose: Total knee arthroplasty (TKA) leaves 11-25% of the patients unsatisfied, and patellofemoral joint pain is one cause. This study aimed to compare the differences between kinematics and load transfer in the same knee with axial internal/external rotation of the femoral component (CoRo) versus a separate axial internal/external trochlear groove rotation (TrRo) which is included in the TKA trochlea design.

Methods: A validated weight-bearing finite element model with modifications of the TKA axial femoral component rotation (CoRo) and a modified trochlear rotation (TrRo) was calculated and analysed.

Results: Compared to the neutrally implanted TKA at 105° of flexion, a 6° external rotation of the trochlear groove reduced the retropatellar stress by 7%, whereas a 3° internal trochlear groove rotation increased the retropatellar stress by 7%. With femoral component rotation, the tibia inlay stress of 6.7 MPa at 60° of flexion was two times higher both with a 3° internal component rotation and a 6° external rotation.

Conclusion: These results demonstrate in the tested TKA design that a trochlear groove rotation can reduce retropatellar stress. Additionally, during the TKA operation, the surgeon should be aware of the significant influence of axial femoral component rotation on mechanical inlay stress during flexion and of the fact that even small changes in the patellofemoral joint may influence the tibiofemoral joint. These results support that an external rotation of the femoral component should be preferred in TKA to avoid anterior knee pain. Furthermore, new developed TKA designs should integrate an externally rotated trochlea groove.

Citing Articles

Does contemporary total knee designs replicate the anatomy of the native trochlea?.

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Factors Influencing the Postoperative Flexion Angle in Cruciate-Sacrificing Rotating Platform of Total Knee Arthroplasty.

Matsuoka D, Inagaki Y, Mawarikado Y, Ogawa M, Seko M, Fujii T Cureus. 2024; 16(8):e66915.

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The Trochlear Paradox in Native Knees and Its Potential Impact on Total Knee Arthroplasty: An MRI-Based Correlation Study Investigating the Effect of Varying Posterior Femoral Condyle Angles on the Patellofemoral Joint.

Rottinger T, Lisitano L, Abelmann-Brockmann J, Rau K, Koenemann N, Fenwick A J Clin Med. 2024; 13(3).

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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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Mismatch between trochlear coronal alignment of arthritic knees and currently available prosthesis: a morphological analysis of 4116 knees and 45 implant designs.

Barroso Rosa S, Hazratwala K, Wilkinson M Knee Surg Sports Traumatol Arthrosc. 2022; 31(8):3116-3123.

PMID: 36456826 PMC: 10356655. DOI: 10.1007/s00167-022-07251-5.

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