The need for secondary resurfacing is affected by trochlear height in total knee arthroplasty

Werth, Lucas; Saffarini, Mo; Amsler, Felix; Abdelkafy, Ashraf; Hirschmann, Michael T.

doi:10.1007/s00167-016-4319-3

Cited by 24 publications

(23 citation statements)

References 23 publications

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“…This flattening of the trochlea in OA knees with increased FA may be an adaption to the resulting increase in lateral patellofemoral stress. However, during TKA, when a surgeon performs a standard resection of the anterior cortex and uses a prosthesis with a uniform anterior femoral thickness regardless of the variable morphology of the femoral trochlea induced by FA, patellofemoral overstuffing or understuffing may occur after TKA [ 10 , 16 ]. The present results may provide some useful information for the patellofemoral morphology design of femoral prostheses to accurately replicate femoral trochlea discrepancies according to FA for TKA.…”

Section: Discussionmentioning

confidence: 99%

High femoral anteversion in osteoarthritic knees, particularly for severe valgus deformity

et al. 2022

J Orthop Traumatol

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Objective Increased femoral anteversion (FA) has been correlated with less varus deformities in osteoarthritic (OA) knees, but the relationship between FA and the degree of valgus deformity in osteoarthritic (OA) knees is still largely unknown. We aimed to thoroughly analyze the distribution of FA in relation to varus or valgus deformities of the lower extremity in OA knees, and to further clarify the relationship between FA and trochlear morphology. Methods 235 lower extremities with OA knees were divided into five groups according to the mechanical tibiofemoral angle: excessive valgus (< − 10°), moderate valgus (− 10° to − 3°), neutral (− 3° to 3°), moderate varus (3° to 10°), and excessive varus (> 10°). FA (measured using the posterior condylar axis [pFA] and the transepicondylar axis [tFA]) was measured, and the relationships of FA to the mechanical tibiofemoral angle and femoral trochlear morphology were identified. Results Excessive FA (pFA ≥ 20°) was observed in 30.2% of all patients and in 58.8% of patients in the excessive valgus group. pFA showed a strong correlation with mechanical tibiofemoral angle (p = 0.018). Both the pFA and the tFA of patients in the excessive valgus group were greater than those in other four groups (all p ≤ 0.037). There were significant correlations between tFA and trochlear parameters, including the sulcus angle (SA), lateral trochlear slope (LTS), and medial trochlear slope (MTS) (all p ≤ 0.028). Conclusion High FA is prevalent, particularly in severe valgus knees, and FA is significantly related to the femoral trochlear morphology in OA knees. With the aim of improving the patellofemoral prognosis and complications, high FA should be considered during total knee arthroplasty.

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Section: Discussionmentioning

confidence: 99%

High femoral anteversion in osteoarthritic knees, particularly for severe valgus deformity

et al. 2022

J Orthop Traumatol

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“…Contemporary implant designs feature a narrower trochlear angle but remain somewhat 'dysplastic', as the groove is shallow [12]. When resurfacing is not performed, excessive height of the prosthetic trochlea is associated with an increased risk of secondary resurfacing [13].…”

Section: Femoral Implantmentioning

confidence: 99%

“…Internal femoral rotation promotes patellar instability and should be looked for first [18]. However, no threshold value has been determined [9][10][11][12][13][14][15][16][17][18].…”

Section: Tibial Plateau Malrotationmentioning

confidence: 99%

Patellar complications after total knee arthroplasty

Putman¹,

Boureau²,

Girard³

et al. 2019

Orthopaedics & Traumatology: Surgery & Research

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“…32 Recently, Werth et al demonstrated the greater tendency for older implant designs with lateral trochlear heights > 5 mm to require secondary patellar resurfacing due to patellofemoral pain following TKA and highlighted that the optimal design characteristics of the patellofemoral joint should take into consideration an anatomically shaped, asymmetric, non-dysplastic trochlear groove with appropriate medial and lateral facet height. 33…”

Section: Shape Of the Componentsmentioning

confidence: 99%

The evolution of patellofemoral prosthetic design in total knee arthroplasty: how far have we come?

Roussot

Haddad

2019

EFORT Open Reviews

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Total knee arthroplasty (TKA) has evolved into a successful, cost-effective treatment for end-stage knee arthrosis. The patellofemoral articulation in TKA has largely been ignored during its development despite being an important determinant of outcome. New technologies still need further development to incorporate the patella in TKA surgical planning and operative technique. Alternative approaches to alignment in TKA will have a secondary impact on patellofemoral mechanics and possibly future implant designs. Technologies that assist with precise implant positioning may alter our understanding and overall practice of TKA. Cite this article: EFORT Open Rev 2019;4:503-512. DOI: 10.1302/2058-5241.4.180094

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The need for secondary resurfacing is affected by trochlear height in total knee arthroplasty

Abstract: Therapeutic study, Level III.

Cited by 24 publications

References 23 publications

High femoral anteversion in osteoarthritic knees, particularly for severe valgus deformity

High femoral anteversion in osteoarthritic knees, particularly for severe valgus deformity

Patellar complications after total knee arthroplasty

The evolution of patellofemoral prosthetic design in total knee arthroplasty: how far have we come?

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