Do surgical patellar interventions restore patellar kinematics in fixed-bearing, cruciate-retaining total knee arthroplasty?

Keshmiri, Armin; Maderbacher, Günther; Baier, Christel; Müller, W; Grifka, Joachim; Springorum, Hans-Robert

doi:10.1016/j.arth.2014.07.008

Cited by 7 publications

(4 citation statements)

References 28 publications

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“…All knees were free of osteoarthritic degeneration, dysplasia or altered lower limb alignment—based on the information of an x-ray and a CT scan in advance of the experiment—and had no prior surgical intervention or history of injury. Patellar kinematic (mediolateral shift, medial: + / lateral: − ; tilt, medial: − / lateral: + ; rotation, medial: + / /lateral: − ; epicondylar distance: distance between patella and anatomical transepicondylar axis) were analyzed using an optical computer navigation system (Knee Patella Tracking Software, BrainLAB; Feldkirchen, Germany) [ 11 – 13 ] before and after HTO with a leg alignment correction of 5° and 10°, respectively [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

Medial Open Wedge High tibial Osteotomy (MOWHTO) does not relevantly alter patellar kinematics: a cadaveric study

Greimel¹,

Maderbacher

Baier

et al. 2020

Arch Orthop Trauma Surg

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Purpose The purpose of this study was to quantify the influence of medial open wedge high tibial osteotomy on patellar kinematics using optical computer navigation, as anterior knee pain infrequently occurs postoperatively and the reason is still being unknown. Methods Ten medial open wedge high tibial osteotomies at supratuberosity level in 5 full body specimens were performed. The effect of the surgical procedure on patellar kinematics, measured at 5 and 10 degrees of leg alignment correction angle, was analyzed and compared to native patellar kinematics during passive motion—regarding patella shift, tilt, epicondylar distance and rotation. Linear mixed models were used for statistical analysis, a two‐sided p value of ≤ 0.05 was considered statistically significant. Results Tilt behavior, medial shift and epicondylar distance did not show a significant difference regarding natural patellar kinematics at both osteotomy levels. Both osteotomy correction angles showed a significant less external rotation of the patella (p < 0.001, respectively) compared to natural kinematics. Conclusions Except less external rotation of the patella, medial open wedge high tibial osteotomy does not seem to relevantly alter patellar alignment during passive motion. Future clinical studies have to prove the effect of MOWHTO on patellar kinematics measured in this experimental setup, especially regarding its influence on anterior knee pain.

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Section: Methodsmentioning

confidence: 99%

Medial Open Wedge High tibial Osteotomy (MOWHTO) does not relevantly alter patellar kinematics: a cadaveric study

Greimel¹,

Maderbacher

Baier

et al. 2020

Arch Orthop Trauma Surg

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“…Also, certain design features of the trochlear groove could alter the patella kinematics [12,35,39], such as the inclusion of a low lateral facet on the anterior flange would predispose the patella to lateral dislocation, while an elevated lateral facet could exacerbate tension in the lateral patellar retinaculum and could lead to excessive contact pressure in the patellofemoral joint [1]. The thickness of the patella or surgical intervention for lateral retinacular release can also affect patellofemoral biomechanics after TKA [20,29]; increased patellar thickness after resurfacing would increase the amount of patella tilting [50] and might increase the contact pressure on the patellofemoral joint [11]. It has been reported that the maximal contact pressures experienced by the patellofemoral joint are well in excess of the compressive yield strength of UHMWPE [42].…”

Section: Discussionmentioning

confidence: 99%

“…Although the biomechanics of the patellofemoral joint have been extensively evaluated with regard to implant design [12,19,22,39] and surgical interventions [20,30,36,45], the contact characteristics of the patella after replacing different features of the femoral component may be intimately linked to the prevalence of patellofemoral joint complications, but such issues have not been well reported on. It was hypothesized that the geometrical design of the anterior trochlear groove could noticeably alter the stress distribution on the patellofemoral joint in both resurfaced and unresurfaced patellae.…”

Section: Introductionmentioning

confidence: 99%

Stress distribution of the patellofemoral joint in the anatomic V-shape and curved dome-shape femoral component: a comparison of resurfaced and unresurfaced patellae

Huang

Hsu

Chang

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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“…Therefore, we defined a large bounding box domain named P1 which encompassed estimated kinematics from cadaver studies [32], [33] and estimated loads from simulation studies [6], [34]. We defined another domain named P2 corresponding to points at the contact boundary.…”

Section: Example Applicationsmentioning

confidence: 99%

An Open-Source Toolbox for Surrogate Modeling of Joint Contact Mechanics

Eskinazi

Fregly

2016

IEEE Trans. Biomed. Eng.

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Goal Incorporation of elastic joint contact models into simulations of human movement could facilitate studying the interactions between muscles, ligaments, and bones. Unfortunately, elastic joint contact models are often too expensive computationally to be used within iterative simulation frameworks. This limitation can be overcome by using fast and accurate surrogate contact models that fit or interpolate input-output data sampled from existing elastic contact models. However, construction of surrogate contact models remains an arduous task. The aim of this paper is to introduce an open-source program called Surrogate Contact Modeling Toolbox (SCMT) that facilitates surrogate contact model creation, evaluation, and use. Methods SCMT interacts with the third party software FEBio to perform elastic contact analyses of finite element models and uses Matlab to train neural networks that fit the input-output contact data. SCMT features sample point generation for multiple domains, automated sampling, sample point filtering, and surrogate model training and testing. Results An overview of the software is presented along with two example applications. The first example demonstrates creation of surrogate contact models of artificial tibiofemoral and patellofemoral joints and evaluates their computational speed and accuracy, while the second demonstrates the use of surrogate contact models in a forward dynamic simulation of an open-chain leg extension-flexion motion. Conclusion SCMT facilitates the creation of computationally fast and accurate surrogate contact models. Additionally, it serves as a bridge between FEBio and OpenSim musculoskeletal modeling software. Significance Researchers may now create and deploy surrogate models of elastic joint contact with minimal effort.

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Do surgical patellar interventions restore patellar kinematics in fixed-bearing, cruciate-retaining total knee arthroplasty?

Cited by 7 publications

References 28 publications

Medial Open Wedge High tibial Osteotomy (MOWHTO) does not relevantly alter patellar kinematics: a cadaveric study

Medial Open Wedge High tibial Osteotomy (MOWHTO) does not relevantly alter patellar kinematics: a cadaveric study

Stress distribution of the patellofemoral joint in the anatomic V-shape and curved dome-shape femoral component: a comparison of resurfaced and unresurfaced patellae

An Open-Source Toolbox for Surrogate Modeling of Joint Contact Mechanics

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