A computer model to simulate patellar biomechanics following total knee replacement: the effects of femoral component alignment

Heegaard, Jean H.; Leyvraz, Pierre-François; Hovey, Chad Brian

doi:10.1016/s0268-0033(01)00020-1

Cited by 72 publications

(47 citation statements)

References 26 publications

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“…2). Similar results were reported in literatures where a high Von Mises stress was primarily located at the distal pole (patellar apex) beneath the patellar tendon origin and along the anterior face of the cancellous bulk [16,25,26]. This highly stressed site may indicate the possible sites of yielding of patella tension and fracture [26].…”

Section: Discussionsupporting

confidence: 88%

“…Also the width of patella, W, was defined as the maximum distance along the medial-lateral direction and was 46 mm for the intact patella, 46.5 mm for the implanted patella. The dimensions of the current specimen are similar to those of a literature: in Baldwin and House's study, the overall width and thickness of the female patellae were 43.5 (36-51) mm and 21.8 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27) mm, respectively. Comparison of stress distributions of intact and implanted patellae should be done in the same geometric scales.…”

Section: Discussionsupporting

confidence: 82%

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Effect of an UHMWPE patellar component on stress fields in the patella: a finite element analysis

Lee

Keyak

2008

Knee Surg Sports Traumatol Arthr

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An increased stress in the patella due to the implantation of a patellar button may also be another potential source of pain in total knee arthroplasty patients. This study assessed the location inside the patella having largest stress change after implantation of an ultra high molecular polyethylene patella button. Finite elements models of the patellae before and after implantation of patellar button were created. Experimentally determined spring constants of muscles and ligaments, and patellofemoral contacting loads were applied to the models at 30 degrees , 60 degrees , and 90 degrees of knee flexion. The Von Mises stress of the intact patella decreased with increased knee flexion, while that of implanted patella increased. Also, the stress range in the implanted patella was 3-9 times higher than in the intact one. The highly stressed region of the intact patella moved proximally with higher knee flexion angles, while that of the implanted model stayed near the central anterior patella. At 90 degrees of knee flexion, the stress in the anterodistal patella increased considerably after implantation of a patella button so that the anterodistal patella may be susceptible to be painful source after the total knee replacement.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 82%

Effect of an UHMWPE patellar component on stress fields in the patella: a finite element analysis

Lee

Keyak

2008

Knee Surg Sports Traumatol Arthr

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“…They have been used to investigate tibial tubercle elevations known as Maquet's procedure (Benvenuti et al 1997;Cohen et al 2003b), varied quadriceps loadings on the patella (Dhaher and Kahn 2002) and femoral component alignment following total knee replacement (Heegaard et al 2001). Moreover, they have highlighted that well-established procedures are less effective than previously understood, such as Cheng et al (1995) who found the Maquet procedure to be effective for only small ranges of motion (<20°).…”

Section: Background and Previous Workmentioning

confidence: 99%

An anatomically based patient-specific finite element model of patella articulation: towards a diagnostic tool

Fernandez

Hunter

2005

Biomech Model Mechanobiol

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A 3D anatomically based patient-specific finite element (FE) model of patello-femoral (PF) articulation is presented to analyse the main features of patella biomechanics, namely, patella tracking (kinematics), quadriceps extensor forces, surface contact and internal patella stresses. The generic geometries are a subset from the model database of the International Union of Physiological Sciences (IUPS) (http://www.physiome.org.nz) Physiome Project with soft tissue derived from the widely used visible human dataset, and the bones digitised from an anatomically accurate physical model with muscle attachment information. The models are customised to patient magnetic resonance images using a variant of free-form deformation, called 'host-mesh' fitting. The continuum was solved using the governing equation of finite elasticity, with the multibody problem coupled through contact mechanics. Additional constraints such as tissue incompressibility are also imposed. Passive material properties are taken from the literature and implemented for deformable tissue with a non-linear micro-structurally based constitutive law. Bone and cartilage are implemented using a 'St-Venant Kirchoff' model suitable for rigid body rotations. The surface fibre directions have been estimated from anatomy images of cadaver muscle dissections and active muscle contraction was based on a steady-state calcium-tension relation. The 3D continuum model of muscle, tendon and bone is compared with experimental results from the literature, and surgical simulations performed to illustrate its clinical assessment capabilities (a Maquet procedure for reducing patella stresses and a vastus lateralis release for a bipartite patella). Finally, the model limitations, issues and future improvements are discussed.

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“…As for rotational alignment, Barrack et al reported that the presence and severity of femoral component internal rotation correlated with patellofemoral complications [6]. In a finite element-rigid body model, patellar maltracking occurred with internal femoral component malrotation [7].…”

mentioning

confidence: 99%

Effect of Tibial Posterior Slope on Knee Kinematics, Quadriceps Force, and Patellofemoral Contact Force After Posterior-Stabilized Total Knee Arthroplasty

Okamoto

Mizu-uchi

Okazaki

et al. 2015

The Journal of Arthroplasty

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A computer model to simulate patellar biomechanics following total knee replacement: the effects of femoral component alignment

Cited by 72 publications

References 26 publications

Effect of an UHMWPE patellar component on stress fields in the patella: a finite element analysis

Effect of an UHMWPE patellar component on stress fields in the patella: a finite element analysis

An anatomically based patient-specific finite element model of patella articulation: towards a diagnostic tool

Effect of Tibial Posterior Slope on Knee Kinematics, Quadriceps Force, and Patellofemoral Contact Force After Posterior-Stabilized Total Knee Arthroplasty

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