Author:
Mizu-uchi Hideki,Ma Yuan,Ishibashi Shojiro,Colwell Clifford W.,Nakashima Yasuharu,D’Lima Darryl D.
Abstract
AbstractPatellofemoral joint complications remain an important issue in total knee arthroplasty. We compared the patellofemoral contact status between cruciate-retaining and posterior-stabilized designs with varying degrees of tibial sagittal and rotational alignment using a computer simulation to ensure proper alignments in total knee arthroplasty. Knee kinematics, patellofemoral contact force and quadriceps force were computed using a musculoskeletal modeling program (LifeMOD/KneeSIM 2010; LifeModeler, Inc., San Clemente, California) during a weight-bearing deep knee bend. Two different posterior tibial slope (PTS)s (3° and 7°) and five different tibial tray rotational alignments (neutral, internal 5° and 10°, and external 5° and 10°) were simulated. Patellofemoral contact area and stresses were next computed using finite element analysis. The patellofemoral contact force for the posterior-stabilized design was substantially lower than the cruciate-retaining design after post-cam contact because of increasing femoral roll-back. Neutral rotational alignment of the tibial component resulted in smaller differences in patellofemoral contact stresses between cruciate-retaining and posterior-stabilized designs for PTSs of 3° or 7°. However, the patellar contact stresses in the cruciate-retaining design were greater than those in posterior-stabilized design at 120° of knee flexion with PTS of 3° combined with internal rotation of the tibial component. Our study provides biomechanical evidence implicating lower PTSs combined with internal malrotation of the tibial component and the resultant increase in patellofemoral stresses as a potential source of anterior knee pain in cruciate-retaining design.
Funder
Donald and Darlene Shiley
Shaffer Family Foundation,United States
Publisher
Springer Science and Business Media LLC
Reference46 articles.
1. Rodricks, D. J., Patil, S., Pulido, P. & Colwell, C. W. Press-fit condylar design total knee arthroplasty. Fourteen to seventeen-year follow-up. J. Bone Joint Surg. Am. 89, 89–95 (2007).
2. Vessely, M. B., Whaley, A. L., Harmsen, W. S., Schleck, C. D. & Berry, D. J. The Chitranjan Ranawat Award: Long-term survivorship and failure modes of 1000 cemented condylar total knee arthroplasties. Clin. Orthop. Relat. Res. 452, 28–34 (2006).
3. Assiotis, A., To, K., Morgan-Jones, R., Pengas, I. P. & Khan, W. Patellar complications following total knee arthroplasty: A review of the current literature. Eur. J. Orthop. Surg. Traumatol. 29(8), 1605–1615 (2019).
4. Berend, M. E., Ritter, M. A., Keating, E. M., Faris, P. M. & Crites, B. M. The failure of all-polyethylene patellar components in total knee replacement. Clin. Orthop. Relat. Res. 388, 105–111 (2001).
5. Collier, J. P., McNamara, J. L., Surprenant, V. A., Jensen, R. E. & Surprenant, H. P. All-polyethylene patellar components are not the answer. Clin. Orthop. Relat. Res. 273, 198–203 (1991).
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