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Patella tracking and patella contact pressure in modular patellofemoral arthroplasty: a biomechanical in vitro analysis

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

In the recent years modular partial knee prosthesis with the opportunity to combine unicompartmental tibiofemoral (UKA) and patellofemoral prosthesis (PFJ) were introduced to the clinics. To date, little is known about the biomechanics of these bi-cruciate retaining prosthetic designs. Aim of this study was to evaluate the influence of a PFJ in bicompartmental arthroplasty (UKA + PFJ) on patella tracking and retropatella pressure distribution.

Methods

A dynamic in vitro knee kinemator simulating an isokinetic extension cycle of the knee was used on eight knee specimen. Patella tracking and patellofemoral contact pressure were evaluated using pressure sensitive films after implantation of a medial UNI and after subsequent implantation of a PFJ.

Results

Whereas the area contact pressure remained the same after PFJ implantation, the contact area was reduced significantly and significantly elevated peak pressures were determined in deep flexion and close to extension. The patella tracking was not significantly altered, however, effects of edge loading could be shown.

Conclusion

When using PFJ prosthesis, one must be aware of altered pressure introduction on the retropatella surface compared to the physiological situation. The elevated peak pressures and reduced contact area may be an argument for patella resurfacing and the problems of edge loading indicate that care must be taken on the correct implantation of the device with no implant overhang.

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Acknowledgments

We thank DePuy Orthopaedics, Kirkel, Germany, for their support of this study. They provided the implants and instrumentation for this study free of charge. However, the sponsor did not participate in the design of the study, in the evaluation of the results, or in the writing of the article. We also thank Simon Wechsler and Berna Richter for their support and input in performing the experiments.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 3, 30625, Hannover, Germany

    Tilman Calliess, Max Ettinger, Ssuheib Schado, Christoph Becher, Christof Hurschler & Sven Ostermeier

  2. Orthopädische Praxis und Gelenk-Klinik, Alte Bundesstrasse 58, 79194, Gundelfingen, Germany

    Sven Ostermeier

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  1. Tilman Calliess
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  2. Max Ettinger
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  3. Ssuheib Schado
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  4. Christoph Becher
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  5. Christof Hurschler
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  6. Sven Ostermeier
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Correspondence to Tilman Calliess.

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Calliess, T., Ettinger, M., Schado, S. et al. Patella tracking and patella contact pressure in modular patellofemoral arthroplasty: a biomechanical in vitro analysis. Arch Orthop Trauma Surg 136, 849–855 (2016). https://doi.org/10.1007/s00402-016-2451-7

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  • DOI: https://doi.org/10.1007/s00402-016-2451-7

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