Influence of Total Knee Arthroplasty on Patellar Kinematics and Patellofemoral Pressure

• Published in: The Journal of arthroplasty Vol. 32; no. 1; pp. 280 - 285
• Main Authors: Tanikawa, Hidenori, MD, PhD, Tada, Mitsunori, PhD, Harato, Kengo, MD, PhD, Okuma, Kazunari, MD, Nagura, Takeo, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2017
• Subjects: Aged, 80 and over; Arthroplasty, Replacement, Knee; Biomechanical Phenomena; Female; Humans; knee biomechanics; Knee Joint - physiopathology; Knee Joint - surgery; Knee Prosthesis; Male; Orthopedics; Patella - physiopathology; Patella - surgery; patellar kinematics; Patellofemoral Joint - physiopathology; Patellofemoral Joint - surgery; patellofemoral pressure; Pressure; Prosthesis Design; Range of Motion, Articular - physiology; Replantation; total knee arthroplasty; patellar kinematics; total knee arthroplasty; patellofemoral pressure; prosthesis design; knee biomechanics
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2016.06.044

Abstract 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 four 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.