Influence of total knee arthroplasty on patellar kinematics and contact characteristics

被引:27
作者
Kainz, Hans [3 ]
Reng, Wolfgang [2 ]
Augat, Peter [3 ]
Wurm, Simone [1 ,3 ]
机构
[1] BG Unfallklin Murnau, D-82418 Murnau, Germany
[2] Klinikum Garmisch Partenkirchen, D-82467 Garmisch Partenkirchen, Germany
[3] Trauma Ctr Murnau, Inst Biomech, D-82418 Murnau, Germany
关键词
IN-VITRO MEASUREMENT; JOINT KINEMATICS; TRACKING;
D O I
10.1007/s00264-011-1270-2
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Femoro-patellar complications are one of the most common problems after total knee arthroplasty (TKA). TKA components that reduce patellar loads and preserve physiological patellar kinematics should reduce these problems. Therefore, we evaluated the patellar kinematics and the retro-patellar contact characteristics in both the intact knee and in the TKA-knee. Eight Thiel-embalmed cadaver knees were tested first intact and then after TKA using rotating as well as gliding inlay and with additional patellar resurfacing while flexing the knee from 0A degrees to 100A degrees. During the examination quadriceps and hamstring forces were applied. TKA with additional patellar resurfacing led to an increased retro-patellar pressure, a decreased contact area and an increased lateral movement. Although patellar kinematics could not be changed by using a gliding inlay compared to a rotating inlay, the gliding inlay improved retro-patellar contact characteristics by reducing the pressure and increasing the contact area, especially in higher flexion. The increased retro-patellar pressure together with the increased lateral movement of the patella after TKA may be one important cause for anterior knee pain appearing after TKA. In view of the improved retro-patellar contact characteristics using a gliding inlay this inlay should be preferred, providing that the posterior cruciate ligament is intact.
引用
收藏
页码:73 / 78
页数:6
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