Quadriceps force during knee extension in different replacement scenarios with a modular partial prosthesis

Calließ, Tilman; Schado, Ssuheib; Richter, B.; Ezechieli, Marco; Ostermeier, Sven

doi:10.1016/j.clinbiomech.2013.11.007

Cited by 8 publications

(7 citation statements)

References 17 publications

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“…In the 0° cross-section, the PRF is relatively small, and thus the decrease in lateral tilt angle (α) has little effect on the PRF vector or the stability of the patella. However, recent studies revealed that quadriceps forces are highest between 70 and 110° [ 11 , 20 , 21 ]. In the 45° cross-section (67.5° of knee flexion), the PRF is relatively high, and thus the decrease in lateral tilt angle (α) might result in a decrease in the PRF vector and subsequent patellar instability.…”

Section: Discussionmentioning

confidence: 99%

Differences between native and prosthetic knees in terms of cross-sectional morphology of the femoral trochlea: a study based on three-dimensional models and virtual total knee arthroplasty

Chen

Yan

et al. 2017

BMC Musculoskelet Disord

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BackgroundThe cross-sectional morphology of the prosthetic knee is crucial to understanding patellar motion and quadriceps strength after total knee arthroplasty. However, few comparative evaluations of the cross-sectional morphology of the femoral trochlea have been performed in the native knee and currently available femoral implants, and the relationship between the trochlear anatomy of prosthetic components and post-operative patellofemoral complications remains unclear. We aimed to investigate the differences in cross-sectional morphology of the femoral trochlea between native knees and prosthetic femoral components.MethodsVirtual total knee arthroplasty was performed, whereby four different femoral components (medial-pivot, Triathlon, NRG and NexGen) were virtually superimposed onto three-dimensional models of 42 healthy femurs. The following morphological parameters were measured in three cross-sections (0, 45 and 90°) of the femoral trochlea: sulcus height, lateral tilt angle, medial tilt angle and sulcus angle. Only statistically significant differences are described further (p < 0.05).ResultsIn the 0° cross-section, sulcus height was smaller in the native knee than in the Triathlon, NRG and NexGen components; all prosthetic components had smaller lateral tilt angles and larger medial tilt angles. In the 45° cross-section, sulcus height was larger in the native knee than in the medial-pivot, Triathlon and NexGen components; both lateral and medial tilt angles were smaller in the prosthetic components. In the 90° cross-section, sulcus height was smaller in the native knee than in the medial-pivot component; all prosthetic components had a larger lateral tilt angle and smaller medial tilt angle. In all cross-sections, the sulcus angle was smaller in the native knee.ConclusionsThe discrepancy between native and prosthetic trochlear geometries suggests altered knee mechanics after total knee arthroplasty, but further cadaveric, computational or fluoroscopic investigations are necessary to clarify the implications of this observation. Our findings can be used to optimize biomechanical guidelines for total knee arthroplasty (patellar resurfacing or non-resurfacing) in Chinese individuals so as to decrease the risk of patellar lateral dislocation, to maintain stability and to optimize extensor kinematics.

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Section: Discussionmentioning

confidence: 99%

Differences between native and prosthetic knees in terms of cross-sectional morphology of the femoral trochlea: a study based on three-dimensional models and virtual total knee arthroplasty

Chen

Yan

et al. 2017

BMC Musculoskelet Disord

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“…By aiming to replace only the damaged compartment, surgeons try to preserve the physiological kinematics and spare bone and soft tissue structures. As a result of this approach, unicompartmental knee arthroplasty (UKA) and patello‐femoral arthroplasty (PFA) have become well‐accepted surgical procedures for the treatment of knee arthritis [7, 11, 28, 32, 45, 51]. However, this technically challenging surgery has yielded satisfactory results only in “high‐volume surgery” centres even when performed using new modern implant designs [1, 29, 57].…”

Section: Introductionmentioning

confidence: 99%

Navigated “small implants” in knee reconstruction

Confalonieri

Biazzo

Cerveri

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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“…Patellar position is also important in late flexion, during which the patella transits over the inter‐condylar notch [17, 28], as this is where the quadriceps forces are highest and where the patella provides the greatest mechanical advantage. Early studies suggested that the quadriceps forces are highest between 0° and 50° of flexion [13, 32], but recent studies with more physiological loading and activities revealed that quadriceps forces are highest between 70° and 110° [15, 35, 38, 44].…”

Section: Introductionmentioning

confidence: 99%