Modern femoral component design in total knee arthroplasty shows a lower patellar contact force during knee flexion compared with its predecessor |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;2. Department of Orthopaedic Surgery, Anshin Hospital, Kobe, Japan;3. Department of Orthopaedic Surgery, Kobe Kaisei Hospital, Kobe, Japan;1. Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany;2. Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany;3. ATOS Clinic Heidelberg, Heidelberg, Germany;1. Orthopedic Physician Associates, Seattle, Washington;2. DePuy Synthes, Warsaw, Indiana;3. Anderson Orthopaedic Research Institute, Alexandria, Virginia;1. North Sydney Orthopaedic and Sports Medicine Centre, Sydney, NSW, Australia;2. University of Notre Dame, Sydney, NSW, Australia;3. The Mater Hospital, Sydney, NSW, Australia;1. Department of Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Osaka, Japan;2. Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan;3. Department of Orthopaedic Surgery, Mandalay Orthopedic Hospital, Myanmar |
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| Abstract: | BackgroundThe relationship between the femoral component design in total knee arthroplasty (TKA) and the patellofemoral contact force, as well as the soft tissue balance, has not been well reported thus far.MethodsTwenty-eight mobile-bearing posterior-stabilized (PS) TKAs using the traditional model (PFC Sigma) and 27 mobile-bearing PS TKAs using the latest model (Attune) were included. Surgeries were performed using the measured resection technique assisted with the computed tomography (CT)-based free-hand navigation system. After all the trial components were placed, patellar contact forces on the medial and lateral sides were measured using two uniaxial ultrathin force transducers with the knee at 0°, 10°, 30°, 60°, 90°, 120°, and 135° of flexion. The joint component gap and the varus ligament balance of the femorotibial joint were also measured. The non-paired Student’s t-test was conducted to compare the values of the two groups.ResultsThe medial patellar contact force was significantly lower for Attune group than for PFC Sigma group at 120° of knee flexion (P = 0.0058). The lateral patellar contact force was also significantly lower for Attune group than PFC Sigma group at 120° and 135° of knee flexion (P = 0.0068 and P = 0.036). The joint component gap, as well as the varus ligament balance, showed no statistically significant difference between the two groups.ConclusionsReduced thickness and width of the anterior flange of the femoral component in the Attune may play a role in low patellar contact force. |
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| Keywords: | Total knee arthroplasty Patellar contact force Soft tissue balance Femoral component design Attune PFC Sigma |
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