Effects of resection thickness on mechanics of resurfaced patellae

Fitzpatrick, Clare K.; Kim, Raymond H.; Ali, Azhar A.; Smoger, Lowell M.; Rullkoetter, Paul J.

doi:10.1016/j.jbiomech.2013.03.016

Cited by 19 publications

(18 citation statements)

References 36 publications

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“…Such models can be used for numerical predictions of patellar strain in order to better understand patellar pathologies such as fracture after total knee arthroplasty (Fitzpatrick et al, 2011(Fitzpatrick et al, , 2013 or anterior knee pain (Ho et al, 2014). In this study we identified and validated anisotropic and isotropic material models for patellar trabecular bone by means of mFE analyses on 20 cadaveric patellae that can be further used in hFE models.…”

Section: Discussionmentioning

confidence: 99%

Identification of elastic properties of human patellae using micro-finite element analysis

Latypova

Maquer²,

Elankumaran

et al. 2016

Journal of Biomechanics

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a b s t r a c tCurrent homogenized finite element (hFE) models of the patella lack a validated material law and mostly overlook trabecular anisotropy. The objective of this study was to identify the elastic constants of patellar trabecular bone. Using μCT scans of 20 fresh-frozen cadaveric patellae, we virtually extracted 200 trabecular cubes (5.3 mm side length). Bone volume fraction and fabric tensor were measured. The elastic constants were identified from six independent load cases using micro finite element (μFE) analyses. Both anisotropic and isotropic material laws were considered. The elastic constants were validated by comparing stiffness, strain and stress between hFE and μFE predictions of 18 patellar sections and six load cases. The hFE section models were built from μCT (anisotropic law) and CT (isotropic law) scans.The homogenized anisotropic model induced less error (13 7 5%) in the global stiffness prediction than the isotropic one (18 7 6%), and less error in the prediction of local apparent strain, stress, and strain energy, compared to the isotropic one. This validated hFE model could be used for future applications, either with the anisotropic constants, or with the isotropic ones when the trabecular fabric is unavailable.

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Section: Discussionmentioning

confidence: 99%

Identification of elastic properties of human patellae using micro-finite element analysis

Latypova

Maquer²,

Elankumaran

et al. 2016

Journal of Biomechanics

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show abstract

“…The average bone volume fraction of the cubic samples corresponded to those reported in the literature (Raux et al, 1975). The predicted peak strains were compared with a similar study of (Fitzpatrick et al, 2013) and were in the same range.…”

Section: Tablementioning

confidence: 64%

“…Several numerical and in vitro studies showed that reduction of patellar thickness can lead to increase of patellar bone strain (Amirouche et al, 2013;Fitzpatrick et al, 2013;Lie et al, 2005), thus increasing risk of the patellar fracture and possibly contributing to AKP symptoms (Draper et al, 2012;Ho et al, 2014). However, these studies were conducted on cadaveric knees.…”

Section: Introductionmentioning

confidence: 99%

A patient-specific model of total knee arthroplasty to estimate patellar strain: A case study

Latypova

Arami

Becce³

et al. 2016

Clinical Biomechanics

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Background: Inappropriate patellar cut during total knee arthroplasty can lead to patellar complications due to increased bone strain. In this study, we evaluated patellar bone strain of a patient who had a deeper patellar cut than the recommended. Methods: A patient-specific model based on patient preoperative data was created. The model was decoupled into two levels: knee and patella. The knee model predicted kinematics and forces on the patella during squat movement. The patella model used these values to predict bone strain after total knee arthroplasty. Mechanical properties of the patellar bone were identified with micro-finite element modeling testing of cadaveric samples. The model was validated with a robotic knee simulator and postoperative X-rays. For this patient, we compared the deeper patellar cut depth to the recommended one, and evaluated patellar bone volume with octahedral shear strain above 1%. Findings: Model predictions were consistent with experimental measurements of the robotic knee simulator and postoperative X-rays. Compared to the recommended cut, the deeper cut increased the critical strain bone volume, but by less than 3% of total patellar volume. Interpretation: We thus conclude that the predicted increase in patellar strain should be within an acceptable range, since this patient had no complaints 8 months after surgery. This validated patient-specific model will later be used to address other questions on groups of patients, to eventually improve surgical planning and outcome of total knee arthroplasty.

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“…Hence, the patella thickness affected PF height. However, it had been reported that a remaining patellar thickness greater than 11 mm was appropriate for minimizing the potential for patellar fracture in a cadaver study [13]. Seo et al reported that the incidence of patellar fracture was found to be associated with thinner post-resection patellar thickness [14].…”

Section: Discussionmentioning

confidence: 99%

Increase of patellofemoral height has decreased maximum knee flexion after total knee arthroplasty of posterior cruciate-substituting prosthesis in a clinical series

Katagiri

Nakamura

Watanabe

et al. 2016

Journal of Orthopaedic Science

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Effects of resection thickness on mechanics of resurfaced patellae

Cited by 19 publications

References 36 publications

Identification of elastic properties of human patellae using micro-finite element analysis

Identification of elastic properties of human patellae using micro-finite element analysis

A patient-specific model of total knee arthroplasty to estimate patellar strain: A case study

Increase of patellofemoral height has decreased maximum knee flexion after total knee arthroplasty of posterior cruciate-substituting prosthesis in a clinical series

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