Failure of metal-backed patellar components after total knee arthroplasty

Dg, Lewallen; Rand, J A

doi:10.1016/0968-0160(95)00006-b

Cited by 12 publications

(2 citation statements)

References 23 publications

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“…An estimated 200,000 are fitted annually within the European Union alone (Datamonitor, 2004;National Joint Registry, 2006). PFJs remain one of the most prevalent causes of revision surgery (Clayton and Thirupathi, 1982;Lewallen and Rand, 1995;Francke and Lachiewicz, 2000;Thadani et al, 2000;Hooper, 2002;Jordan et al, 2005) in total knee replacements (TKRs) and as a result there is increasing interest in the PFJ, principally in wear modelling of replacement prostheses. Furthermore, there is interest developing in isolated replacement of the PFJ.…”

Section: Introductionmentioning

confidence: 99%

In vitro simulation and quantification of wear within the patellofemoral joint replacement

Ellison

Barton

Esler

et al. 2008

Journal of Biomechanics

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Section: Introductionmentioning

confidence: 99%

In vitro simulation and quantification of wear within the patellofemoral joint replacement

Ellison

Barton

Esler

et al. 2008

Journal of Biomechanics

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“…This finding suggests that the prosthetic components should be kept as thin as possible, in order to reduce the bone resection required to make space for them. Unfortunately, the literature includes reports of patellar implant failures due to excessive stresses in thin polyethylene components [11][12][13][14], and so thin implants are not advisable. It is tempting to leave as much bone as possible, but excessive 'stuffing' of the front of the knee can inhibit knee flexion.…”

Section: Introductionmentioning

confidence: 99%

Patellar resection during total knee arthroplasty: effect on bone strain and fracture risk

Lie

Gloria

Amis

et al. 2004

Knee Surg Sports Traumatol Arthrosc

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Patellae in small knees, or after severe patellar erosion, may be vulnerable to fracture after resection during arthroplasty. The patellar remnant may be thin, while the polyethylene component has a standard thickness. Anterior patellar bone strain was measured in cadaver knees loaded via the quadriceps, from 0 to 90 degrees flexion, with the patella intact, and after resections to 16, 13 and 11 mm thick and replacement by an 8-mm-thick polyethylene component. Strain increased significantly with knee flexion with constant 500 N quadriceps tension. Resection caused significant changes from intact values in knee flexion and extension and no significant effect at 30 degrees flexion. In flexion, bending caused the anterior surface to become more convex, with high tensile bone strains. In extension, resection caused negative anterior strains, representing bending in the opposite direction, with large tensile strains on the cut posterior surface. For normal activities, such as rising from a chair (1.8 kN quadriceps tension) the patella appears safe against fracture with a minimal resection to 16 mm thick. An eroded patella resected to 11 mm thickness may be at risk of fracture with that loading.

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