Patellofemoral joint after total knee arthroplasty

Matsuda, Shuichi; Ishinishi, Takashi; White, Stephen E.; Whiteside, Leo A.

doi:10.1016/s0883-5403(97)90010-3

Cited by 103 publications

(46 citation statements)

References 21 publications

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“…There was no significant difference in the average and maximum retropatellar pressures after resurfacing. Increased pressures have been reported after resurfacing [3,21,24], and the combination of increased pressure and decreased contact area may lead to increased polyethylene wear and loosening [3,21,34]. In view of our findings of reduced contact area without significantly increased pressure we would not recommend routine patellar resurfacing.…”

Section: Discussionmentioning

confidence: 67%

Retropatellar contact characteristics in total knee arthroplasty with and without patellar resurfacing

Fuchs

Schütte

Witte

et al. 2000

International Orthopaedics

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Total knee replacement with and without patellar resurfacing was performed in 6 cadaver specimens. The contact pressure and contact area between femur and patella was measured at 60°of flexion. In comparison to specimens without resurfacing the specimens with small size resurfacing showed a significant decrease in contact area, whereas average and maximum pressure were unchanged. In specimens with medium size resurfacing, contact area and average pressure increased slightly, whereas maximum pressure increased significantly. Patellar resurfacing did not change the retropatellar pressure, but was associated with reduced contact area.Résumé 6 cadavres ont été examinés après implantation d'une prothèse totale du genou avec et sans implants de restructuration de la surface rotulienne. Les mesures de la pression et de la surface de contact ont été réalisées avec une flexion du genou à un angle de 60°. En comparant les résultats de genoux sans implants et genoux avec implants de la rotule de taille "petite", on remarque que ces derniers ont causé une diminution significative de la surface de contact rétro-rotulienne. Les pressions moyenne et maximum n'ont pas changé de manière déterminante. Les implants de taille "moyenne" ont conduit à une augmentation considérable de la pression maximum et à une diminution significative de la force alors que la surface de contact et la pression moyenne ont elles, légèrement augmenté. Après la pose des deux types d'implants de la rotule on a constatée une réduction significative de la surface de contact, mais ne pas de la pression rétro-rotulienne.

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Section: Discussionmentioning

confidence: 67%

Retropatellar contact characteristics in total knee arthroplasty with and without patellar resurfacing

Fuchs

Schütte

Witte

et al. 2000

International Orthopaedics

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“…In 1997, Matsuda et al published their study concerning the effects of TKA on patellofemoral contact area and contact stress [31]. It is noteworthy that they only performed static measurements in six different flexion angles in five specimens.…”

Section: Discussionmentioning

confidence: 99%

Patellofemoral contact patterns before and after total knee arthroplasty: an in vitro measurement

et al. 2013

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BackgroundPatellofemoral complications are one of the main problems after Total Knee Arthroplasty (TKA). Retropatellar pressure distribution after TKA can contribute to these symptoms. Therefore we evaluated retropatellar pressure distribution subdivided on the ridge, medial and lateral surface on non-resurfaced patella before and after TKA. Additionally, we analyzed axial femorotibial rotation and quadriceps load before and after TKA.MethodsSeven fresh frozen cadaver knees were tested in a force controlled knee rig before and after TKA (Aesculap, Tuttlingen, Germany, Columbus CR) while isokinetic flexing the knee from 20° to 120° under weight bearing. Ridge, medial and lateral retropatellar surface were defined and pressure distribution was dynamically measured while quadriceps muscles and hamstring forces were applied. Aside axial femorotibial rotation and quadriceps load was recorded.ResultsThere was a significant change of patella pressure distribution before and after TKA (p = 0.004). In physiological knees pressure distribution on medial and lateral retropatellar surface was similar. After TKA the ridge of the patella was especially in higher flexion grades strongly loaded (6.09 +/−1.31 MPa) compared to the natural knee (2.92 +/−1.15 MPa, p < 0.0001). Axial femorotibial rotation showed typical internal rotation with increasing flexion both before and after TKA, but postoperatively it was significantly lower. The average amount of axial rotation was 3.5° before and after TKA 1.3° (p = 0.001). Mean quadriceps loading after implantation of knee prosthesis did not change significantly (575 N ±60 N in natural knee and after TKA 607 N ±96 N; p = 0.28).ConclusionsThe increased retropatellar pressure especially on the ridge may be one important reason for anterior knee pain after TKA. The trochlea of the femoral component might highly influence the pressure distribution of the non-resurfaced retropatellar surface. Additionally, lower axial femorotibial rotation after TKA might lead to patella maltracking. Changing the design of the prosthesis or a special way of patella shaping might increase the conformity of the patella to trochlea to maintain natural contact patterns.

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“…Clinically, adverse responses have included anterior knee pain, fracture, malalignment, and subluxation/dislocation. This implant is subject to very high stress [202,203] and does overload the parameters for material design. Currently, the most common design is a dome-shaped configuration with a thinner bony substrate, which we know as a less conforming surface, being subject to eccentric loading and high shear [204] and may be prone to failure [205].…”

Section: Total Knee Replacementmentioning

confidence: 99%

Orthopedic Implant Retrieval and Failure Analysis

Jones

Tsao²,

Topoleski

2012

Degradation of Implant Materials

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Orthopedic devices make up a major percentage of the medical devices being implanted today. Success rates exceeding 95% have been reported. However, their longevity is compromised by fatigue, wear, corrosion, and other degradative mechanisms. Adverse biologic responses to products from these different mechanisms can lead to significant bone loss and may even compromise subsequent surgeries. It is imperative that we fully understand what mechanisms are in play and carefully evaluate strategies to minimize, if not eliminate, these degradation processes. Devices retrieved at revision surgery and at autopsy have provided us with important information regarding the performance of orthopedic implants. Surface characterization of the implant, biomechanical analyses, and histological analysis of the tissues surrounding the implant can provide us with information not available through other sources. This chapter will review the significance of retrieved implants to the long-term survival of these implants.

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Patellofemoral joint after total knee arthroplasty

Cited by 103 publications

References 21 publications

Retropatellar contact characteristics in total knee arthroplasty with and without patellar resurfacing

Retropatellar contact characteristics in total knee arthroplasty with and without patellar resurfacing

Patellofemoral contact patterns before and after total knee arthroplasty: an in vitro measurement

Orthopedic Implant Retrieval and Failure Analysis

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