Abstract
BackgroundPatellofemoral complications are one of the major issues after total knee arthroplasty (TKA). Excessive patellofemoral joint pressure is associated with complications after TKA surgery, and the amount of patellar osteotomy has a direct effect on patellofemoral joint pressure. The purpose of this study was to evaluate the influence of patella thickness on patellofemoral pressure in TKA.MethodsFive freshly frozen cadavers were operated with a custom-made Stryker posterior stabilizing type knee joint prosthesis. Patellofemoral joint pressure was measured using a pressure sensor, with the knee joint flexed from 90 to 110 degrees, and with patellar thickness of − 2 mm to + 4 mm.ResultsIncreasing or decreasing patellar thickness significantly increased or decreased patellofemoral pressure. Regarding knee flexion angle, patellofemoral pressure increased with increasing patellar thickness at all flexion angles, but the pressure increase was greatest at 90 degrees of knee flexion and smallest at 110 degrees.ConclusionsThe amount of patellar osteotomy influences the patellofemoral pressure. Surgeons should avoid increasing patella thickness, since the resulting increased patellofemoral pressure may reduce knee joint function.
Highlights
Patellofemoral complications are one of the major issues after total knee arthroplasty (TKA)
We isolated the part of the femoral component where it meets the patella and placed the 6-axis pressure sensor inside the femoral component, the patellofemoral pressure measured in this study was a total of compressive force occurs on the isolated part of the femoral component (Fig. 2)
Patellofemoral pressure increased with increasing patellar thickness at all flexion angles, but the pressure increase was greatest at 90 degrees of knee flexion and smallest at 110
Summary
Patellofemoral complications are one of the major issues after total knee arthroplasty (TKA). It has been reported that 4–12% of all TKA revisions are due to the patellofemoral joint, such as anterior knee pain, loosening of the patellar component, and patellar fracture [2]. Five to 45% of post-TKA patients complain of residual anterior knee pain [3, 4]. Details about the cause of anterior knee pain are still unknown, Tibiofemoral and patellofemoral joint pressures were difficult to measure in the past. In 2012, a TKA insert trial with a pressure sensor built-in was used in the first publication on obtaining soft tissue balance using intraoperative tibiofemoral joint pressure as an indicator [7]
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