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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2011

01.11.2011 | Knee

The influence of patellar dislocation on the femoro-tibial loading during total knee arthroplasty

verfasst von: Nobuyuki Yoshino, Nobuyoshi Watanabe, Yukihisa Fukuda, Yoshinobu Watanabe, Shinro Takai

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 11/2011

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Abstract

Purpose

Balancing the gap is essential in total knee arthroplasty (TKA). The purpose of this study was to quantify the influence of patellar position on femoro-tibial joint load in TKA. We hypothesized that resetting of the patella increased medial joint load and decreased lateral joint load.

Methods

Our original tensor system was used during posterior-stabilized (PS) and cruciate-retaining (CR) total knee arthroplasty (TKA) using medial para-patellar approach (MPP) or sub-vastus approach (SV).

Results

In PS-TKA, by resetting the patella, the ratios between medial and lateral compartments were not changed in both extension and flexion position using MPP and were significantly changed in flexion position using SV. In CR-TKA, by resetting the patella, the load of the lateral component decreased and the ratios between medial and lateral compartments were changed significantly in both extension and flexion position using SV.

Conclusion

It is important to be aware that, when performing CR-KA, the load of the lateral compartment will decrease by resetting the patella using SV.

Level of evidence

Therapeutic studies investigating the results of treatment, Level II.
Literatur
1.
Zurück zum Zitat Anglin C, Brimacombe JM, Hodgson AJ, Masri BA, Geridanus NV, Tonetti J, Wilson DR (2008) Determinant of patellar tracking in total knee arthroplasty. Clin Biomech 23:900–910CrossRef Anglin C, Brimacombe JM, Hodgson AJ, Masri BA, Geridanus NV, Tonetti J, Wilson DR (2008) Determinant of patellar tracking in total knee arthroplasty. Clin Biomech 23:900–910CrossRef
2.
Zurück zum Zitat Anglin C, Brimacombe JM, Wilson DR, Masri BA, Geridanus NV, Tonetti J, Hodgson AJ (2008) Intraoperative versus weightbearing patellar kinematics in total knee arthroplasty: a cadeveric study. Clin Biomech 23:60–70CrossRef Anglin C, Brimacombe JM, Wilson DR, Masri BA, Geridanus NV, Tonetti J, Hodgson AJ (2008) Intraoperative versus weightbearing patellar kinematics in total knee arthroplasty: a cadeveric study. Clin Biomech 23:60–70CrossRef
3.
Zurück zum Zitat Attfield SF, Warren-Forward M, Wilton T, Sambatakakis A (1994) Measurement of soft tissue imbalance in total knee arthroplasty using electronic instrument. Med Eng Phys 16:501–505PubMedCrossRef Attfield SF, Warren-Forward M, Wilton T, Sambatakakis A (1994) Measurement of soft tissue imbalance in total knee arthroplasty using electronic instrument. Med Eng Phys 16:501–505PubMedCrossRef
4.
Zurück zum Zitat Becher C, Huber R, Thermann H, Paessler HH, Skrbensky G (2008) Effects of a contoured articular prosthetic device on tibiofemoral peak contact pressure: a biomechanical study. Knee Surg Sport Trauma Arthrosc 16:56–63CrossRef Becher C, Huber R, Thermann H, Paessler HH, Skrbensky G (2008) Effects of a contoured articular prosthetic device on tibiofemoral peak contact pressure: a biomechanical study. Knee Surg Sport Trauma Arthrosc 16:56–63CrossRef
5.
Zurück zum Zitat Booth RE (2003) Tensioners: essential for accurate performance of TKA. Orthopedics 26:962–964PubMed Booth RE (2003) Tensioners: essential for accurate performance of TKA. Orthopedics 26:962–964PubMed
6.
Zurück zum Zitat Cila E, Guzel V, Ozalay M et al (2002) Subvastus versus medial parapatellar approach in total knee arthroplasty. Arch Orthop Trauma Surg 122:65–68PubMedCrossRef Cila E, Guzel V, Ozalay M et al (2002) Subvastus versus medial parapatellar approach in total knee arthroplasty. Arch Orthop Trauma Surg 122:65–68PubMedCrossRef
7.
Zurück zum Zitat D’Lima DD, Patil S, Steklov N, Slamin JE, Colwell CW Jr (2006) Tibial force measured in vivo after total knee arthroplasty. J Arthroplasty 21:255–262PubMedCrossRef D’Lima DD, Patil S, Steklov N, Slamin JE, Colwell CW Jr (2006) Tibial force measured in vivo after total knee arthroplasty. J Arthroplasty 21:255–262PubMedCrossRef
8.
Zurück zum Zitat Gejo R, McGarry MH, Jun B-J, Hofer JK, Komura T, Lee TQ (2010) Biomechanical effect of patellar positioning on intraoperative knee joint gap measurement in total knee arthroplasty. Clin Biomech 25:352–358CrossRef Gejo R, McGarry MH, Jun B-J, Hofer JK, Komura T, Lee TQ (2010) Biomechanical effect of patellar positioning on intraoperative knee joint gap measurement in total knee arthroplasty. Clin Biomech 25:352–358CrossRef
9.
Zurück zum Zitat In Y, Kong CG, Sur YJ, Choi SS (2009) TKA using the subvastus approach and lateral release in patient with permanent post-traumatic patellar dislocation: a report of two cases. Knee Surg Sports Traumatol Arthrosc 17:254–259PubMedCrossRef In Y, Kong CG, Sur YJ, Choi SS (2009) TKA using the subvastus approach and lateral release in patient with permanent post-traumatic patellar dislocation: a report of two cases. Knee Surg Sports Traumatol Arthrosc 17:254–259PubMedCrossRef
10.
Zurück zum Zitat Insall JN, Easley ME (2001) Total knee replacement. In: Insall JN, Scott WN (eds) Surgery of the knee, 3rd edn. Churchill-Livingstone, New York, pp 1553–1620 Insall JN, Easley ME (2001) Total knee replacement. In: Insall JN, Scott WN (eds) Surgery of the knee, 3rd edn. Churchill-Livingstone, New York, pp 1553–1620
11.
Zurück zum Zitat Kadoya Y, Kobayashi A, Komatsu T, Nakagawa S, Yamano Y (2001) Effects of posterior cruciate ligament resection on the tibiofemoral joint gap. Clin Orthop Relat Res 391:210–217PubMedCrossRef Kadoya Y, Kobayashi A, Komatsu T, Nakagawa S, Yamano Y (2001) Effects of posterior cruciate ligament resection on the tibiofemoral joint gap. Clin Orthop Relat Res 391:210–217PubMedCrossRef
12.
Zurück zum Zitat Matsumoto T, Muratsu H, Tsumura N, Mizuno K, Kuroda R, Yoshiya S, Kurosaka M (2006) Joint gap kinematics in posterior-stabilized total knee arthroplasty measured by a new tensor with the navigation system. J Biomech Eng 128:867–871PubMedCrossRef Matsumoto T, Muratsu H, Tsumura N, Mizuno K, Kuroda R, Yoshiya S, Kurosaka M (2006) Joint gap kinematics in posterior-stabilized total knee arthroplasty measured by a new tensor with the navigation system. J Biomech Eng 128:867–871PubMedCrossRef
13.
Zurück zum Zitat Matsumoto T, Mizuno K, Muratsu H, Tsumura N, Fukase N, Kubo S, Yoshiya S, Kurosaka M, Kuroda R (2007) Influence of intra-operative joint gap on post-operative flexion angle in osteoarthritis patients undergoing posterior-stabilized total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 15:1013–1018PubMedCrossRef Matsumoto T, Mizuno K, Muratsu H, Tsumura N, Fukase N, Kubo S, Yoshiya S, Kurosaka M, Kuroda R (2007) Influence of intra-operative joint gap on post-operative flexion angle in osteoarthritis patients undergoing posterior-stabilized total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 15:1013–1018PubMedCrossRef
14.
Zurück zum Zitat Matsumoto T, Muratsu H, Kubo S, Matsushita T, Kurosaka M, Kuroda R (2010) Soft tissue tension in posterior-stabilized total knee arthroplasty with a navigation system. J Arthroplasty 24:358–364CrossRef Matsumoto T, Muratsu H, Kubo S, Matsushita T, Kurosaka M, Kuroda R (2010) Soft tissue tension in posterior-stabilized total knee arthroplasty with a navigation system. J Arthroplasty 24:358–364CrossRef
15.
Zurück zum Zitat Mayman D, Plaskos C, Kendoff D, Wernecke G, Pearle AD, Laskin R (2009) Ligament tension in the ACL-deficient knee: assessment of medial and lateral gaps. Clin Orthop Relat Res 467:1621–1628PubMedCrossRef Mayman D, Plaskos C, Kendoff D, Wernecke G, Pearle AD, Laskin R (2009) Ligament tension in the ACL-deficient knee: assessment of medial and lateral gaps. Clin Orthop Relat Res 467:1621–1628PubMedCrossRef
16.
Zurück zum Zitat Morris BA, D’Lima DD, Slamin J, kovacevic N, Arms SW, Townsend CP, Colwell CW Jr (2001) e-Knee: evolution of the electronic knee prosthesis. J Bone Joint Surg 23(Suppl 2, Part 1):62–66 Morris BA, D’Lima DD, Slamin J, kovacevic N, Arms SW, Townsend CP, Colwell CW Jr (2001) e-Knee: evolution of the electronic knee prosthesis. J Bone Joint Surg 23(Suppl 2, Part 1):62–66
17.
Zurück zum Zitat Schroer WC, Diesfield PJ, Reedy ME, LeMarr AR (2008) Mini-subcastus approach for total knee arthroplasty. J Arthroplasty 23:19–25PubMedCrossRef Schroer WC, Diesfield PJ, Reedy ME, LeMarr AR (2008) Mini-subcastus approach for total knee arthroplasty. J Arthroplasty 23:19–25PubMedCrossRef
18.
Zurück zum Zitat Takai S, Yoshino N, Isshiki T, HirAsawa Y (2003) Kneeling view: a new roentgenographic technique to assess the rotation deformity and alignment of the distal femur. J Arthroplasty 18:478–483PubMedCrossRef Takai S, Yoshino N, Isshiki T, HirAsawa Y (2003) Kneeling view: a new roentgenographic technique to assess the rotation deformity and alignment of the distal femur. J Arthroplasty 18:478–483PubMedCrossRef
19.
Zurück zum Zitat Winemakaer MJ (2002) Perfect balance in total knee arthroplasty. J Arthroplasty 17:2–10CrossRef Winemakaer MJ (2002) Perfect balance in total knee arthroplasty. J Arthroplasty 17:2–10CrossRef
20.
Zurück zum Zitat Yoshino N, Watanabe N, Watanabe Y, Fukuda Y, Takai S (2009) Measurement of tension between osteotomy gaps in patella everted and reset position during total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 17:484–490PubMedCrossRef Yoshino N, Watanabe N, Watanabe Y, Fukuda Y, Takai S (2009) Measurement of tension between osteotomy gaps in patella everted and reset position during total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 17:484–490PubMedCrossRef
Metadaten
Titel
The influence of patellar dislocation on the femoro-tibial loading during total knee arthroplasty
verfasst von
Nobuyuki Yoshino
Nobuyoshi Watanabe
Yukihisa Fukuda
Yoshinobu Watanabe
Shinro Takai
Publikationsdatum
01.11.2011
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 11/2011
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1648-0

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