Evaluation of Patella Anatomy for Total Knee Arthroplasty Approaches

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Jun 10

PMID 38854214

Authors

Baris Kafa

Hasan B Ilgaz

Mehmet Ulkir

Shanzeda Khan Efil

Affiliations

Soon will be listed here.

Abstract

Background: The patella, or kneecap, is a sesamoid bone situated deep to the fascia latae and the tendinous fibers of the rectus femoris. The medial and lateral facets of the patella articulate with the medial and lateral condyles of the femur, respectively, to form the patellofemoral component of the knee joint. When joint cartilage is destroyed due to osteoarthritis, inflammatory arthritis, post-traumatic degenerative joint disease, or osteonecrosis/joint collapse with cartilage loss, a surgical treatment called knee arthroplasty, or total knee arthroplasty (TKA), is used to rebuild the knee joint.

Objectives: The purpose of our study is to provide a detailed morphometric analysis of the human patella.

Methods: A total of 168 patellae (86 left, 82 right) were examined. Eleven parameters were determined to evaluate patella morphometry, and the bones were also evaluated with the Wiberg classification.

Result: Type I patella was observed in 13 samples (7.74%); 109 (64.88%) and 46 (27.38%) were Type II and Type III, respectively. In the statistical analysis, significant differences were found between the right and left patellae in terms of patellar thickness, vertical ridge length, and Wiberg angle (p<0.05). There were also significant differences between the Wiberg types and the medial articular width and lateral articular width (p<0.05).

Conclusion: In order to avoid potential difficulties during knee surgery, it is crucial to understand the typical morphological and morphometric properties of the patella. We believe that this study will be useful to surgeons who perform surgical approaches to the knee and to clinicians who evaluate the diseases of the region.

References

Uehara K, Kadoya Y, Kobayashi A, Ohashi H, Yamano Y . Anthropometry of the proximal tibia to design a total knee prosthesis for the Japanese population. J Arthroplasty. 2002; 17(8):1028-32. DOI: 10.1054/arth.2002.35790. View

Taj S, Raghunath G, Gurusamy K, Begum Z, Kaveripakkam V, Dharshini P . Morphometric Analysis of Dry Human Patella and Patellar Facets. Cureus. 2022; 14(3):e22879. PMC: 8981413. DOI: 10.7759/cureus.22879. View

Iranpour F, Merican A, Amis A, Cobb J . The width:thickness ratio of the patella: an aid in knee arthroplasty. Clin Orthop Relat Res. 2008; 466(5):1198-203. PMC: 2311467. DOI: 10.1007/s11999-008-0130-x. View

Fucentese S, von Roll A, Koch P, Epari D, Fuchs B, Schottle P . The patella morphology in trochlear dysplasia--a comparative MRI study. Knee. 2006; 13(2):145-50. DOI: 10.1016/j.knee.2005.12.005. View

Sidharthan S, Yau A, Almeida B, Shea K, Greditzer 4th H, Jones K . Patterns of Articular Cartilage Thickness in Pediatric and Adolescent Knees: A Magnetic Resonance Imaging-Based Study. Arthrosc Sports Med Rehabil. 2021; 3(2):e381-e390. PMC: 8128992. DOI: 10.1016/j.asmr.2020.09.029. View

Baldwin J, House C . Anatomic dimensions of the patella measured during total knee arthroplasty. J Arthroplasty. 2005; 20(2):250-7. DOI: 10.1016/j.arth.2004.09.027. View

Katchy A, Agu A, Esom E, Ikele I, Okeke M, Ugwu A . The morphometric analysis of the male cadaveric native knees of the ethnic igbos of South East Nigeria and its implication in total knee replacement. Niger J Clin Pract. 2020; 23(7):1013-1021. DOI: 10.4103/njcp.njcp_700_19. View

Fox A, Wanivenhaus F, Rodeo S . The basic science of the patella: structure, composition, and function. J Knee Surg. 2012; 25(2):127-41. DOI: 10.1055/s-0032-1313741. View

Wen-Wei Hsu R . The management of the patella in total knee arthroplasty. Chang Gung Med J. 2007; 29(5):448-57. View

10.

Assi C, Kheir N, Samaha C, Deeb M, Yammine K . Optimizing patellar positioning during total knee arthroplasty: an anatomical and clinical study. Int Orthop. 2017; 41(12):2509-2515. DOI: 10.1007/s00264-017-3557-4. View

11.

Muhamed R, Saralaya V, Murlimanju B, Chettiar G . magnetic resonance imaging morphometry of the patella bone in South Indian population. Anat Cell Biol. 2017; 50(2):99-103. PMC: 5509906. DOI: 10.5115/acb.2017.50.2.99. View

12.

Arendt E, Dejour D . Patella instability: building bridges across the ocean a historic review. Knee Surg Sports Traumatol Arthrosc. 2012; 21(2):279-93. DOI: 10.1007/s00167-012-2274-1. View

13.

Mont M, Rifai A, Baumgarten K, Sheldon M, Hungerford D . Total knee arthroplasty for osteonecrosis. J Bone Joint Surg Am. 2002; 84(4):599-603. DOI: 10.2106/00004623-200204000-00014. View

14.

Kim T, Chung B, Kang Y, Chang C, Seong S . Clinical implications of anthropometric patellar dimensions for TKA in Asians. Clin Orthop Relat Res. 2008; 467(4):1007-14. PMC: 2650045. DOI: 10.1007/s11999-008-0557-0. View

15.

Vaidya S, Ranawat C, Aroojis A, Laud N . Anthropometric measurements to design total knee prostheses for the Indian population. J Arthroplasty. 2000; 15(1):79-85. DOI: 10.1016/s0883-5403(00)91285-3. View

16.

Yilmaz B, Cicek E, Sirin E, Ozdemir G, Karakus O, Muratli H . A magnetic resonance imaging study of abnormalities of the patella and patellar tendon that predispose children to acute patellofemoral dislocation. Clin Imaging. 2016; 42:83-87. DOI: 10.1016/j.clinimag.2016.11.010. View

17.

Pfirrmann C, Zanetti M, Romero J, Hodler J . Femoral trochlear dysplasia: MR findings. Radiology. 2000; 216(3):858-64. DOI: 10.1148/radiology.216.3.r00se38858. View

18.

Shang P, Zhang L, Hou Z, Bai X, Ye X, Xu Z . Morphometric measurement of the patella on 3D model reconstructed from CT scan images for the southern Chinese population. Chin Med J (Engl). 2014; 127(1):96-101. View

19.

Hsu H, Luo Z, Rand J, An K . Influence of patellar thickness on patellar tracking and patellofemoral contact characteristics after total knee arthroplasty. J Arthroplasty. 1996; 11(1):69-80. DOI: 10.1016/s0883-5403(96)80163-x. View

20.

Servien E, Ait Si Selmi T, Neyret P . [Study of the patellar apex in objective patellar dislocation]. Rev Chir Orthop Reparatrice Appar Mot. 2003; 89(7):605-12. View