Influence of Total Knee Arthroplasty on Patellar Kinematics and Patellofemoral Pressure

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• 作者：Hidenori Tanikawa ; MD ; PhD^a ; ; Mitsunori Tada ; PhD^b ; Kengo Harato ; MD ; PhD^c ; Kazunari Okuma ; MD^a ; Takeo Nagura ; MD ; PhD^d
• 关键词：patellofemoral pressure ; patellar kinematics ; total knee arthroplasty ; knee biomechanics ; prosthesis design
• 刊名：The Journal of Arthroplasty
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：32
• 期：1
• 页码：280-285
• 全文大小：1303 K
• 卷排序：32

文摘

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.MethodsUsing 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.ResultsThe 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.ConclusionAlthough 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.