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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2018

01-06-2018 | Knee

Medial stabilized and posterior stabilized TKA affect patellofemoral kinematics and retropatellar pressure distribution differently

Authors: Alexander Glogaza, Christian Schröder, Matthias Woiczinski, Peter Müller, Volkmar Jansson, Arnd Steinbrück

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2018

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Abstract

Purpose

Patellofemoral kinematics and retropatellar pressure distribution change after total knee arthroplasty (TKA). It was hypothesized that different TKA designs will show altered retropatellar pressure distribution patterns and different patellofemoral kinematics according to their design characteristics.

Methods

Twelve fresh-frozen knee specimens were tested dynamically in a knee rig. Each specimen was measured native, after TKA with a posterior stabilized design (PS) and after TKA with a medial stabilized design (MS). Retropatellar pressure distribution was measured using a pressure sensitive foil which was subdivided into three areas (lateral and medial facet and patellar ridge). Patellofemoral kinematics were measured by an ultrasonic-based three-dimensional motion system (Zebris CMS20, Isny Germany).

Results

Significant changes in patellofemoral kinematics and retropatellar pressure distribution were found in both TKA types when compared to the native situation. Mean retropatellar contact areas were significantly smaller after TKA (native: 241.1 ± 75.6 mm2, MS: 197.7 ± 74.5 mm2, PS: 181.2 ± 56.7 mm2, native vs. MS p < 0.001; native vs. PS p < 0.001). The mean peak pressures were significantly higher after TKA. The increased peak pressures were however seen in different areas: medial and lateral facet in the PS-design (p < 0.001), ridge in the MS design (p < 0.001). Different patellofemoral kinematics were found in both TKA designs when compared to the native knee during flexion and extension with a more medial patella tracking.

Conclusion

Patellofemoral kinematics and retropatellar pressure change after TKA in different manner depending on the type of TKA used. Surgeons should be aware of influencing the risks of patellofermoral complications by the choice of the prosthesis design.
Literature
1.
Arnout N, Vanlommel L, Vanlommel J et al (2015) Post-cam mechanics and tibiofemoral kinematics: a dynamic in vitro analysis of eight posterior-stabilized total knee designs. Knee Surg Sports Traumatol Arthrosc 23:3343–3353CrossRefPubMed
2.
Becher C, Heyse TJ, Kron N et al (2009) Posterior stabilized TKA reduce patellofemoral contact pressure compared with cruciate retaining TKA in vitro. Knee Surg Sports Traumatol Arthrosc 17:1159–1165CrossRefPubMed
3.
4.
Breugem SJ, Van Ooij B, Haverkamp D et al (2014) No difference in anterior knee pain between a fixed and a mobile posterior stabilized total knee arthroplasty after 7.9 years. Knee Surg Sports Traumatol Arthrosc 22:509–516CrossRefPubMed
5.
Brimacombe JM, Wilson DR, Hodgson AJ et al (2009) Effect of calibration method on Tekscan sensor accuracy. J Biomech Eng 131:034503CrossRefPubMed
6.
Chew JT, Stewart NJ, Hanssen AD et al (1997) Differences in patellar tracking and knee kinematics among three different total knee designs. Clin Orthop Relat Res 345:87–98CrossRef
7.
Dennis DA, Komistek RD, Mahfouz MR et al (2003) Multicenter determination of in vivo kinematics after total knee arthroplasty. Clin Orthop Relat Res 416:37–57CrossRef
8.
Fuchs S, Schutte G, Witte H et al (2000) Retropatellar contact characteristics in total knee arthroplasty with and without patellar resurfacing. Int Orthop 24:191–193CrossRefPubMedPubMedCentral
9.
Fuchs S, Skwara A, Tibesku CO et al (2005) Retropatellar contact characteristics before and after total knee arthroplasty. Knee 12:9–12CrossRefPubMed
10.
Heyse TJ, Becher C, Kron N et al (2010) Patellofemoral pressure after TKA in vitro: highly conforming vs. posterior stabilized inlays. Arch Orthop Trauma Surg 130:191–196CrossRefPubMed
11.
Hsu HC, Luo ZP, Rand JA et al (1996) Influence of patellar thickness on patellar tracking and patellofemoral contact characteristics after total knee arthroplasty. J Arthroplasty 11:69–80CrossRefPubMed
12.
Kainz H, Reng W, Augat P et al (2012) Influence of total knee arthroplasty on patellar kinematics and contact characteristics. Int Orthop 36:73–78CrossRefPubMed
13.
Katchburian MV, Bull AM, Shih YF et al (2003) Measurement of patellar tracking: assessment and analysis of the literature. Clin Orthop Relat Res 412:241–259CrossRef
14.
Komistek RD, Dennis DA, Mabe JA et al (2000) An in vivo determination of patellofemoral contact positions. Clin Biomech (Bristol Avon) 15:29–36CrossRef
15.
Konno T, Onodera T, Nishio Y et al (2014) Correlation between knee kinematics and patellofemoral contact pressure in total knee arthroplasty. J Arthroplasty 29:2305–2308CrossRefPubMed
16.
Lee TQ, Gerken AP, Glaser FE et al (1997) Patellofemoral joint kinematics and contact pressures in total knee arthroplasty. Clin Orthop Relat Res 340:257–266CrossRef
17.
Leichtle UG, Wunschel M, Leichtle CI et al (2014) Increased patellofemoral pressure after TKA: an in vitro study. Knee Surg Sports Traumatol Arthrosc 22:500–508CrossRefPubMed
18.
19.
Mcwalter EJ, Cibere J, Macintyre NJ et al (2007) Relationship between varus-valgus alignment and patellar kinematics in individuals with knee osteoarthritis. J Bone Joint Surg Am 89:2723–2731CrossRefPubMed
20.
Moonot P, Mu S, Railton GT et al (2009) Tibiofemoral kinematic analysis of knee flexion for a medial pivot knee. Knee Surg Sports Traumatol Arthrosc 17:927–934CrossRefPubMed
21.
Muller O, Lo J, Wunschel M et al (2009) Simulation of force loaded knee movement in a newly developed in vitro knee simulator. Biomed Tech (Berl) 54:142–149CrossRef
22.
Ostermeier S, Buhrmester O, Hurschler C et al (2005) Dynamic in vitro measurement of patellar movement after total knee arthroplasty: an in vitro study. BMC Musculoskelet Disord 15:6:30CrossRef
23.
Petersen W, Rembitzki IV, Bruggemann GP et al (2014) Anterior knee pain after total knee arthroplasty: a narrative review. Int Orthop 38:319–328CrossRefPubMed
24.
Schindler OS (2012) Basic kinematics and biomechanics of the patellofemoral joint part 2: the patella in total knee arthroplasty. Acta Orthop Belg 78:11–29PubMed
25.
Schroder C, Steinbruck A, Muller T et al. (2015) Rapid prototyping for in vitro knee rig investigations of prosthetized knee biomechanics: comparison with cobalt-chromium alloy implant material. Biomed Res Int 2015:185142PubMedPubMedCentral
26.
27.
Steinbruck A, Fottner A, Schroder C et al (2017) Influence of mediolateral tibial baseplate position in TKA on knee kinematics and retropatellar pressure. Knee Surg Sports Traumatol Arthrosc 25(8):2602–2608CrossRefPubMed
28.
Steinbruck A, Schroder C, Woiczinski M et al (2013) Patellofemoral contact patterns before and after total knee arthroplasty: an in vitro measurement. Biomed Eng Online 12:58CrossRefPubMedPubMedCentral
29.
Steinbruck A, Schroder C, Woiczinski M et al (2016) Femorotibial kinematics and load patterns after total knee arthroplasty: an in vitro comparison of posterior-stabilized versus medial-stabilized design. Clin Biomech (Bristol Avon) 33:42–48CrossRef
30.
Steinbruck A, Schroder C, Woiczinski M et al (2016) Influence of tibial rotation in total knee arthroplasty on knee kinematics and retropatellar pressure: an in vitro study. Knee Surg Sports Traumatol Arthrosc 24:2395–2401CrossRefPubMed
31.
32.
Stiehl JB, Komistek RD, Dennis DA et al (2001) Kinematics of the patellofemoral joint in total knee arthroplasty. J Arthroplasty 16:706–714CrossRefPubMed
33.
Tanikawa H, Tada M, Harato K et al (2017) Influence of total knee arthroplasty on patellar kinematics and patellofemoral pressure. J Arthroplasty 32:280–285CrossRefPubMed
Metadata
Title
Medial stabilized and posterior stabilized TKA affect patellofemoral kinematics and retropatellar pressure distribution differently
Authors
Alexander Glogaza
Christian Schröder
Matthias Woiczinski
Peter Müller
Volkmar Jansson
Arnd Steinbrück
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4772-7

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