TY - JOUR
T1 - Influence of Total Knee Arthroplasty on Patellar Kinematics and Patellofemoral Pressure
AU - Tanikawa, Hidenori
AU - Tada, Mitsunori
AU - Harato, Kengo
AU - Okuma, Kazunari
AU - Nagura, Takeo
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background Patellofemoral complications are one of the main problems after total knee arthroplasty (TKA). The design of the TKA component may affect the patellar biomechanics, which may be associated with this postoperative complication. The purpose of this study was to assess the influence of TKA and prosthesis designs on the patellar kinematics and patellofemoral pressure. Methods Using fresh-frozen cadavers, we measured the patellofemoral pressure, patella offset, and patella tilt in the following 4 conditions: normal knee (patella replacement only), cruciate-retaining TKA, condylar-stabilizing TKA, and posterior-stabilized TKA. Results The patellofemoral pressure increased significantly after the cruciate-retaining TKA and condylar-stabilizing TKA compared with the normal knee. The patella offset in the normal knee decreased with increasing knee flexion angles, while the patella offset in the TKA knees did not change significantly through the full range of motion. The amount of lateral patella tilt in the normal knee was significantly larger than the TKA knees in the full range of motion. Conclusion Although the femoral components are designed to reproduce an anatomical patellar tracking, the physiological patellar kinematics were not observed. Relatively high patellofemoral pressure and kinematic change after TKA may be associated with postoperative complications such as the anterior knee pain.
AB - Background Patellofemoral complications are one of the main problems after total knee arthroplasty (TKA). The design of the TKA component may affect the patellar biomechanics, which may be associated with this postoperative complication. The purpose of this study was to assess the influence of TKA and prosthesis designs on the patellar kinematics and patellofemoral pressure. Methods Using fresh-frozen cadavers, we measured the patellofemoral pressure, patella offset, and patella tilt in the following 4 conditions: normal knee (patella replacement only), cruciate-retaining TKA, condylar-stabilizing TKA, and posterior-stabilized TKA. Results The patellofemoral pressure increased significantly after the cruciate-retaining TKA and condylar-stabilizing TKA compared with the normal knee. The patella offset in the normal knee decreased with increasing knee flexion angles, while the patella offset in the TKA knees did not change significantly through the full range of motion. The amount of lateral patella tilt in the normal knee was significantly larger than the TKA knees in the full range of motion. Conclusion Although the femoral components are designed to reproduce an anatomical patellar tracking, the physiological patellar kinematics were not observed. Relatively high patellofemoral pressure and kinematic change after TKA may be associated with postoperative complications such as the anterior knee pain.
KW - knee biomechanics
KW - patellar kinematics
KW - patellofemoral pressure
KW - prosthesis design
KW - total knee arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=84997523893&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84997523893&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2016.06.044
DO - 10.1016/j.arth.2016.06.044
M3 - Article
C2 - 27480826
AN - SCOPUS:84997523893
VL - 32
SP - 280
EP - 285
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
SN - 0883-5403
IS - 1
ER -