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International Orthopaedics
Published in: International Orthopaedics 3/2014

01-03-2014 | Original Paper

Evaluation of patellofemoral joint in ADVANCE® Medial-pivot total knee arthroplasty

Authors: Nobuaki Chinzei, Kazunari Ishida, Tomoyuki Matsumoto, Yuichi Kuroda, Atsushi Kitagawa, Ryosuke Kuroda, Toshihiro Akisue, Kotaro Nishida, Masahiro Kurosaka, Nobuhiro Tsumura

Published in: International Orthopaedics | Issue 3/2014

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Abstract

Purpose

ADVANCE® Medial Pivot (MP) (Wright Medical) total knee arthroplasty (TKA) was established to replicate normal tibio-femoral knee joint kinematics, however, its influence on the patello-femoral (PF) joint is unclear. The purpose in this study was to assess the PF joint conditions in Advance MP TKA, via radiography and three-dimensional image-matching software.

Methods

Ten subjects with osteoarthritis were treated with the ADVANCE MP TKA. Pre-operatively and one month after surgery, skyline views at 30, 60, and 90° of flexion were taken, and patella shift and tilt were measured. With 2D–3D registration techniques using software, implant orientations were matched with the pre-operative CT and changes in the anterior part of the femoral prosthesis, condylar twist angle (CTA) for femoral rotation, and tibial rotation were evaluated. The relationships between morphological and rotational changes were evaluated.

Results

There were significant differences in patella tilt at 60° and patella shift at all angles between pre- and post-operation (p < 0.05). No correlation was found between morphological changes in the anterior femur with patella tilt and shift. A positive correlation between postoperative CTA and patella shift at 90° was found (p < 0.05); however, no correlation was found between rotational alignment of the tibial component and patella tilt and shift.

Conclusions

ADVANCE MP TKA changed patello-femoral joint kinematics, compared to that found before surgery. The kinematic features were mainly due to the design concepts for tibio-femoral joint motion, indicating the difficulty to reproduce normal patello-femoral joint kinematics after TKA.
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Metadata
Title
Evaluation of patellofemoral joint in ADVANCE® Medial-pivot total knee arthroplasty
Authors
Nobuaki Chinzei
Kazunari Ishida
Tomoyuki Matsumoto
Yuichi Kuroda
Atsushi Kitagawa
Ryosuke Kuroda
Toshihiro Akisue
Kotaro Nishida
Masahiro Kurosaka
Nobuhiro Tsumura
Publication date
01-03-2014
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 3/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-2043-x

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