External rotation of the femoral component decreases patellofemoral contact stress in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 23, 3266–3272 (2015) doi:10.1007/s00167-014-3103-5

External rotation of the femoral component decreases patellofemoral contact stress in total knee arthroplasty

Terashima, T., Onodera, T., Sawaguchi, N. et al.
Knee

Purpose

The purpose of this study was to investigate the relationship between patellofemoral (PF) contact stress in vivo and the alignment of the femoral component in patients after total knee arthroplasty (TKA).

 

Methods

Thirty knees with medial compartment osteoarthritis that underwent mobile-bearing TKA with modified gap technique were evaluated. Surgery was performed using a subvastus approach to eliminate the effect of the approach to muscle balance, with a computed tomography-based navigation system (Vector Vision 1.61; Brain Lab, Heimstetten, Germany). PF contact stress was measured by a Flexiforce pressure sensor (Nitta Co., Ltd., Osaka, Japan) intraoperatively, and the results were compared with the alignment of the femoral component after TKA.

 

Results

The PF contact stress was not correlated with sagittal and coronal alignment of the femoral component and patellar tracking, whereas rotational alignment of the femoral component was negatively correlated with PF contact stress (r = −0.718, p < 0.01).

 

Conclusions

Regarding the alignment of the femoral component, only the rotational alignment of the femoral component was correlated with PF contact stress. PF contact stress decreased more as the femoral component rotated more externally.

 

Level of evidence

Case control study, Level III.


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