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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2017

05.07.2017 | Knee

Mediolateral femoral component position in TKA significantly alters patella shift and femoral roll-back

verfasst von: Arnd Steinbrück, Christian Schröder, Matthias Woiczinski, Florian Schmidutz, Peter E. Müller, Volkmar Jansson, Andreas Fottner

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 11/2017

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Abstract

Purpose

Increased retropatellar pressure and altered kinematics are associated with anterior knee pain and unsatisfied patients after total knee arthroplasty (TKA). Since malposition of the implant is believed to contribute to postoperative pain, we performed this in vitro study to evaluate the influence of mediolateral femoral component position on retropatellar pressure as well as tibio-femoral and patella kinematics.

Methods

For the test, a fixed-bearing TKA was implanted in eight fresh frozen cadaver specimens. To determine the impact of mediolateral (ML) position, three variants of femoral components (3-mm medialization, neutral position and 3-mm lateralization) were produced using rapid prototyping replicas. In a knee rig, a loaded squat from 20° to 120° of flexion was applied. Retropatellar pressure distribution was measured with a pressure-sensitive film. Additionally, an ultrasonic-based three-dimensional motion analysis system was used to register patello- and tibio-femoral kinematics.

Results

ML translation of the femoral component by 3 mm did not lead to a significant alteration in retropatellar peak pressure (medial 6.5 ± 2.5 MPa vs. lateral 6.0 ± 2.4 MPa). Following the ML translation of the femoral component, the patella was significantly shifted and tilted in the same directions. Varying the ML femoral component position also led to a significant alteration in femoral roll-back.

Conclusion

In day-by-day use, ML position should be chosen with care since there is a significant influence on patella shift and femoral roll-back. Retropatellar pressure is not significantly altered, so there is no clear evidence of an impact on anterior knee pain.
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Metadaten
Titel
Mediolateral femoral component position in TKA significantly alters patella shift and femoral roll-back
verfasst von
Arnd Steinbrück
Christian Schröder
Matthias Woiczinski
Florian Schmidutz
Peter E. Müller
Volkmar Jansson
Andreas Fottner
Publikationsdatum
05.07.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 11/2017
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4633-4

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