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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-08-2014 | Knee

Tibio-femoral and patello-femoral joint kinematics during navigated total knee arthroplasty with patellar resurfacing

Authors: C. Belvedere, A. Ensini, A. Leardini, V. Dedda, A. Feliciangeli, F. Cenni, A. Timoncini, P. Barbadoro, S. Giannini

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2014

Abstract

Purpose

In total knee arthroplasty, surgical navigation systems provide tibio-femoral joint (TFJ) tracking for relevant bone preparation, disregarding the patello-femoral joint (PFJ). Therefore, the important intra-operative assessment of the effect of component positioning, including the patella, on the kinematics of these two joints is not available. The objective of this study is to explore in vivo whether accurate tracking of the patella can result in a more physiological TFJ and PFJ kinematics during surgery.

Methods

Ten patients underwent navigated knee replacement with patellar resurfacing. A secondary system was used to track patellar motion and PFJ kinematics using a special tracker. Patellar resection plane position and orientation were recorded using an instrumented probe. During all surgical steps, PFJ kinematics was measured in addition to TFJ kinematics.

Results

Abnormal PFJ motion patterns were observed pre-operatively at the impaired knee. Patellar resection plane orientation on sagittal and transverse planes of 3.9° ± 9.0° and 0.4° ± 4.1° was found. A good restoration of both TFJ and PFJ kinematics was observed in all replaced knees after resurfacing, in particular the rotations in the three anatomical planes and medio-lateral patellar translation.

Conclusions

Patella tracking results in nearly physiological TFJ and PFJ kinematics in navigated knee arthroplasty with resurfacing. The intra-operative availability also of PFJ kinematics can support the positioning not only of the patellar component in case of resurfacing, but also of femoral and tibial components.

Level of evidence

II.

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Title: Tibio-femoral and patello-femoral joint kinematics during navigated total knee arthroplasty with patellar resurfacing
Authors: C. Belvedere
A. Ensini
A. Leardini
V. Dedda
A. Feliciangeli
F. Cenni
A. Timoncini
P. Barbadoro
S. Giannini
Publication date: 01-08-2014
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-013-2825-0

At a glance: The STEP trials

Springer Medicine

Tibio-femoral and patello-femoral joint kinematics during navigated total knee arthroplasty with patellar resurfacing

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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