Abstract
For many reasons, management of patella in total knee arthroplasty is an important issue: The natural or prosthetic patellofemoral joint is subjected to tremendous compressive or shear forces, up to 8 times the body weight, and these forces may exceed the strength of polyethylene (61); Contact areas between the patellar component and the trochlear groove are always smaller than in the normal patellofemoral joint; this is true for all patellar designs (21% according to Rand) (55); Kinematics of a prosthetic patellofemoral joint during flexion does not reproduce the kinematics of a normal knee. One of the differences is the medial contact that occurs in the prosthetic joint (63, 64); Patellofemoral joint is an integral part of the knee joint and cannot be isolated. There are inseparable interactions between the tibiofemoral joint and the patellofemoral joint: any tibiofemoral malpositioning may adversely affect the patellofemoral kinematics; At last, no patellar component design is able to address the anatomic spectrum of the trochlear groove and patella (25).
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