The effect of different quadriceps loading patterns on tibiofemoral joint kinematics and patellofemoral contact pressure during simulated partial weight-bearing knee flexion

Wünschel, Markus; Leichtle, Ulf; Obloh, Christian; Wülker, Nikolaus; Müller, Otto

doi:10.1007/s00167-010-1359-y

Cited by 60 publications

(60 citation statements)

References 30 publications

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“…In conjunction with our previous findings concerning tibiofemoral motion [15], our results on patellofemoral and patellotibial kinematics give a good overview on overall knee motion which might help to interpret the complex interactions of femur, tibia and patella connected in a kinematic chain. Regarding the rotations around the respective AP-axes, a more lateral quadriceps force led to an increased varus rotation of the tibia (external rotation of the tibial head), while the patella rotated internally with respect to both, femur and tibia, at the same time.…”

Section: Discussionsupporting

confidence: 80%

“…On the contrary, we detected a significant effect on the ML-movement of the center of patellofemoral pressure (COP) in a previous study with the same specimens [15]. Combining these results, the large shift of the COP (up to 6 mm laterally) seems to be caused mainly by the rotational components of patellar movement.…”

Section: Discussionsupporting

confidence: 47%

“…In our experiments, an almost physiological quadriceps force progression could be simulated during the flexion movement. Although there remain some limitations, like the small portion of simulated bodyweight or the choice of constant hamstring forces -which most in vitro studies have in common and which have been extensively discussed [13][14][15] -this innovative setting is considered a major advancement compared to the simulation of a constant quadriceps force.…”

Section: Discussionmentioning

confidence: 99%

“…Seven fresh-frozen human cadaveric knee specimens (out of the eight specimens in [15]) with a mean age of 73.3 (standard deviation: 9.5 years) were studied. The specimens were carefully examined and knees with severe degeneration and osteoarthrosis or deformities like trochlear dysplasia were excluded.…”

Section: Methodsmentioning

confidence: 99%

“…However, the experimental setups used in former in vitro studies only enabled the simulation of constant muscle forces over the whole flexion range. On the contrary, our advanced knee simulator [13][14][15] is able to apply an almost physiological force progression and additionally simulate different force distributions of the quadriceps muscle.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The influence of asymmetric quadriceps loading on patellar tracking — An in vitro study

Lorenz¹,

Müller²,

Köhler³

et al. 2012

The Knee

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The influence of asymmetric quadriceps loading on patellar tracking — An in vitro study

Lorenz¹,

Müller²,

Köhler³

et al. 2012

The Knee

Self Cite

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Sectioning the medial patellofemoral ligament alters patellofemoral joint kinematics and contact mechanics

Stephen

Kader

Lumpaopong

et al. 2013

Journal Orthopaedic Research

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Medial patellofemoral ligament (MPFL) disruption may alter patellofemoral joint (PFJ) kinematics and contact mechanics, potentially causing pain and joint degeneration. In this controlled laboratory study, we investigated the hypothesis that MPFL transection would change patellar tracking and PFJ contact pressures and increase the distance between the attachment points of the MPFL. Eight fresh frozen dissected cadaveric knees were mounted in a rig with the quadriceps and ITB loaded to 205 N. An optical tracking system measured joint kinematics, and pressure sensitive film between the patella and trochlea measured PFJ contact pressures. Length patterns of the distance between the femoral and patellar attachments of the MPFL were measured using a suture led to a linear displacement transducer. Measurements were repeated with the MPFL intact and following MPFL transection. A significant increase in the distance between the patellar and femoral MPFL attachment points was noted following transection (p < 0.05). MPFL transection resulted in significantly increased lateral translation and lateral tilt of the patella in early flexion (p < 0.05). Peak and mean medial PFJ contact pressures were significantly reduced and peak lateral contact pressures significantly elevated in early knee flexion following MPFL transection (p < 0.05). MPFL transection resulted in significant alterations to PFJ tracking and contact pressures, which may affect articular cartilage health. The medial patellofemoral ligament (MPFL) is the most important patellofemoral joint (PFJ) stabilizer from 0 to 30˚of knee flexion, contributing 50-60% of the passive resistance to patellar lateral translation.1-4 Patellar dislocation as a consequence of trochlear dysplasia and patella alta were previously highlighted in the literature.5-7 Given its anatomic position, lateral patellar dislocation will almost always damage the MPFL. 8Rupture of the MPFL occurs in 95-100% and injury in 100% of patients suffering patellar dislocation.9-11 PFJ dislocation is linked to the development of abnormal contact stress and joint degeneration. 12,13 This, alongside reports of recurrent instability rates >50% with non-operative management, 14 have perhaps contributed to the recent increase in primary management with operative MPFL repair. 15,16 Given the high levels of patient dissatisfaction following patellar dislocation, the associated incidence of MPFL rupture, and the link to joint degeneration, we hypothesized that MPFL transection would allow the patella to track more laterally than normal, and that this would lead to elevated articular contact pressure on the lateral facet of the PFJ. MATERIALS AND METHODS Specimen PreparationFive male and three female right-sided, fresh-frozen cadaveric knees of mean age 73.5 years (range: 46-88) were obtained from a tissue bank, following approval from a local Research Ethics Committee. Each specimen was cut to 20 cm of femur and 15 cm of tibia, with no deformity apparent on visual inspection. Specimens were stored at À2...

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How does laxity after single radius total knee arthroplasty compare with the native knee?

et al. 2014

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Patients with total knee arthroplasties (TKAs) continue to report dissatisfaction in functional outcome. Stability is a major factor contributing to functionality of TKAs. Implants with single-radius (SR) femoral components are proposed to increase stability throughout the arc of flexion. Using computer navigation and loaded cadaveric legs, we characterized the "envelope of laxity" (EoL) offered by a SR cruciate retaining (CR)-TKA compared with that of the native knee through the arc of flexion in terms of anterior drawer, varus/valgus stress, and internal/external rotation. In both the native knee and the TKA laxity increased with increasing knee flexion. Laxities measured in the three planes of motion were generally comparable between the native knee and TKA from 0˚to 110o f flexion. Our results indicate that the SR CR-TKA offers appropriate stability in the absence of soft tissue deficiency. ß

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The effect of different quadriceps loading patterns on tibiofemoral joint kinematics and patellofemoral contact pressure during simulated partial weight-bearing knee flexion

Cited by 60 publications

References 30 publications

The influence of asymmetric quadriceps loading on patellar tracking — An in vitro study

The influence of asymmetric quadriceps loading on patellar tracking — An in vitro study

Sectioning the medial patellofemoral ligament alters patellofemoral joint kinematics and contact mechanics

How does laxity after single radius total knee arthroplasty compare with the native knee?

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