The effects of the sagittal plane malpositioning of the patella and concomitant quadriceps hypotrophy on the patellofemoral joint: a finite element analysis

Akşahin, Ertuğrul; Kocadal, Onur; Aktekin, Cem Nuri; Kaya, Defne; Pepe, Murad; Yılmaz, Serdar; Yüksel, Halil Yalçın; Biçimoğlu, Ali

doi:10.1007/s00167-014-3421-7

Cited by 12 publications

(22 citation statements)

References 23 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sagittal patellar tilt leads to pathological loading by changing patellofemoral joint geometry as well as contact areas in cases of patellofemoral knee pain following tibial nailing [1]. To the best of our knowledge, the literature contains no study analysing the relationship between the chondromalacia patella and sagittal patellar tilt which might be a causative factor in patellar cartilage lesions by changing contact values and loading distributions.…”

Section: Introductionmentioning

confidence: 99%

“…The purposes of this study are: (1) to evaluate sagittal plane alignment in patients with chondromalacia patella via magnetic resonance imaging (MRI); (2) to analyse the relationship between the location of the patellar cartilaginous lesion and sagittal alignment; and (3) to investigate the relationship between the sagittal plane malalignment and patellofemoral loadings using finite element analysis. In the current study, it was hypothesized that the malalignment of the patella in the sagittal plane was related to chondromalacia patellae and this causes supraphysiological loadings on the patellofemoral joint.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sagittal plane tilting deformity of the patellofemoral joint: a new concept in patients with chondromalacia patella

Akşahin¹,

Aktekin

Kocadal³

et al. 2016

Knee Surg Sports Traumatol Arthrosc

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sagittal plane tilting deformity of the patellofemoral joint: a new concept in patients with chondromalacia patella

Akşahin¹,

Aktekin

Kocadal³

et al. 2016

Knee Surg Sports Traumatol Arthrosc

Self Cite

View full text Add to dashboard Cite

show abstract

“…Computational methods such as finite element (FE) analysis and joint-segment modeling are examples of musculoskeletal modeling that can estimate in vivo joint loading and mechanics [17,65,66]. Recent FE studies have been used to estimate measures such as bone strain [18] and have examined the effect of factors such as ligament reconstruction [67,68] and malpositioning of the patella [69,70]. These models allow for the simulation of six-degrees-of-freedom (three rotations and three translations) patella motion and are validated through comparison with cadaveric results.…”

Section: In Silicomentioning

confidence: 99%

Patellofemoral Mechanics: a Review of Pathomechanics and Research Approaches

Wheatley

Rainbow

Clouthier

2020

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Purpose of ReviewThe patellofemoral joint is a complicated articulation of the patella and femur that is prone to pathologies. The purpose of this review is to report on the current methods of investigating patellofemoral mechanics, factors that affect joint function, and future directions in patellofemoral joint research with emerging technologies and techniques. Recent Findings While previous hypotheses have suggested that the patella is only a moment arm extender, recent literature has suggested that the patella influences the control of knee moments and forces acting on the tibia as well as contributes to various aspects of patellar function with minimal neural input. With advancements in simulating a six-degrees-of-freedom patellofemoral joint, we have gained a better understanding of patella motion and have shown that geometry and muscle activations impact patella mechanics. Research into influences on patella mechanics from other joints such as the hip and foot has become more prevalent. Summary In this review, we report current in vivo, in vitro, and in silico approaches to studying the patellofemoral joint. Kinematic and anatomical factors that affect patellofemoral joint function such as patella alta and tilt or bone morphology and ligaments are discussed. Moving forward, we suggest that advanced in vivo dynamic imaging methods coupled to musculoskeletal simulation will provide further understanding of patellofemoral pathomechanics and allow engineers and clinicians to design interventions to mitigate or prevent patellofemoral pathologies.

show abstract

“…cartilage damage and implant impingement) play an important role. [9][10][11][12][13] Thus, countersinkable biodegradable implants are on the rise to obtain anatomic reduction of articular fractures and to avoid secondary implant removal. Burkhart et al 14 found no significant differences in stability between headless compression screws (HCS) and lag screws in a biomechanical cadaver study with smaller cartilage defects produced by the HCS.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical dynamic comparison of biodegradable pins and titanium screws for operative stabilization of displaced radial head fractures

Wagner

Feucht

Konstantinidis

et al. 2019

Proc Inst Mech Eng H

View full text Add to dashboard Cite

For radial head osteosynthesis, biodegradable implants are gaining in importance to minimize cartilage destruction and implant impingement and to supersede implant removal. Since loss of reduction and pseudarthrosis remain challenging complications, new implants should at least provide comparable biomechanical properties as commonly used metal implants. The objective of this study was to compare the treatment by polylactide pins to titanium screws and to quantify the produced cartilage defects. Eight pairs of human cadaver radii with a standardized Mason type II fracture were stabilized either by two 2.0-mm polylactide pins or titanium screws. The produced cartilage defects were quantified using an image analyzing software. Quasi-static loading was performed axially and transversally for 10 cycles each between 10 and 50 N. Afterward, implant loosening was tested by axial loading up to 10,000 cycles, followed by load to failure testing. Polylactide pins showed less construct stiffness under axial (p = 0.017) and transversal (p = 0.012) loading, and one polylactide pins construct failed after two cycles of transversal loading. At axial loading, a high correlation between bone mineral density and construct stiffness was observed among polylactide pins (R = 0.667; p = 0.071), which was not seen among titanium screws (R = 0.262; p = 0.531). No difference in implant loosening was recorded after 10,000 cycles (p = 0.237); however, one polylactide pins construct failed after 30 cycles and failure loads were higher for titanium screws (p=0.017). Polylactide pin produced smaller cartilage defects (p=0.012). In conclusion, simple radial head fractures treated by polylactide pins show less biomechanical stability than treated by titanium screws, particularly in osteoporotic bone which might lead to secondary loss of reduction. Due to smaller cartilage defects and equal properties under continuous loading, polylactide pins might represent a gentle alternative in patients with good bone quality making subsequent implant removal redundant.

show abstract

The effects of the sagittal plane malpositioning of the patella and concomitant quadriceps hypotrophy on the patellofemoral joint: a finite element analysis

Cited by 12 publications

References 23 publications

Sagittal plane tilting deformity of the patellofemoral joint: a new concept in patients with chondromalacia patella

Sagittal plane tilting deformity of the patellofemoral joint: a new concept in patients with chondromalacia patella

Patellofemoral Mechanics: a Review of Pathomechanics and Research Approaches

Biomechanical dynamic comparison of biodegradable pins and titanium screws for operative stabilization of displaced radial head fractures

Contact Info

Product

Resources

About