Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study
<p>Abstract</p> <p>Background</p> <p>Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral osteoarthritis. However, results of later conversion to total knee replacement may be compromised by periprosthetic bone loss. Previous cli...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-06-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://www.josr-online.com/content/7/1/28 |
| _version_ | 1811278179837411328 |
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| author | van Jonbergen Hans-Peter W Innocenti Bernardo Gervasi Gian Labey Luc Verdonschot Nico |
| author_facet | van Jonbergen Hans-Peter W Innocenti Bernardo Gervasi Gian Labey Luc Verdonschot Nico |
| author_sort | van Jonbergen Hans-Peter W |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral osteoarthritis. However, results of later conversion to total knee replacement may be compromised by periprosthetic bone loss. Previous clinical studies have demonstrated a decrease in distal femoral bone mineral density after patellofemoral joint replacement. It is unclear whether this is due to periprosthetic stress shielding. The main objective of the current study was to evaluate the stress shielding effect of prosthetic replacement with 2 different patellofemoral prosthetic designs and with a total knee prosthesis.</p> <p>Methods</p> <p>We developed a finite element model of an intact patellofemoral joint, and finite element models of patellofemoral joint replacement with a Journey PFJ prosthesis, a Richards II prosthesis, and a Genesis II total knee prosthesis. For each of these 4 finite element models, the average Von Mises stress in 2 clinically relevant regions of interest were evaluated during a simulated squatting movement until 120 degrees of flexion.</p> <p>Results</p> <p>During deep knee flexion, in the anterior region of interest, the average Von Mises stress with the Journey PFJ design was comparable to the physiological knee, while reduced by almost 25% for both the Richards II design and the Genesis II total knee joint replacement design. The average Von Mises stress in the supracondylar region of interest was similar for both patellofemoral prosthetic designs and the physiological model, with slightly lower stress for the Genesis II design.</p> <p>Conclusions</p> <p>Patellofemoral joint replacement results in periprosthetic stress-shielding, although to a smaller degree than in total knee replacement. Specific patellofemoral prosthetic design properties may result in differences in femoral stress shielding.</p> |
| first_indexed | 2024-04-13T00:31:10Z |
| format | Article |
| id | doaj.art-783eb2fb86164fd9b25fbaf316e2fcb5 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-13T00:31:10Z |
| publishDate | 2012-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-783eb2fb86164fd9b25fbaf316e2fcb52022-12-22T03:10:28ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2012-06-01712810.1186/1749-799X-7-28Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element studyvan Jonbergen Hans-Peter WInnocenti BernardoGervasi GianLabey LucVerdonschot Nico<p>Abstract</p> <p>Background</p> <p>Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral osteoarthritis. However, results of later conversion to total knee replacement may be compromised by periprosthetic bone loss. Previous clinical studies have demonstrated a decrease in distal femoral bone mineral density after patellofemoral joint replacement. It is unclear whether this is due to periprosthetic stress shielding. The main objective of the current study was to evaluate the stress shielding effect of prosthetic replacement with 2 different patellofemoral prosthetic designs and with a total knee prosthesis.</p> <p>Methods</p> <p>We developed a finite element model of an intact patellofemoral joint, and finite element models of patellofemoral joint replacement with a Journey PFJ prosthesis, a Richards II prosthesis, and a Genesis II total knee prosthesis. For each of these 4 finite element models, the average Von Mises stress in 2 clinically relevant regions of interest were evaluated during a simulated squatting movement until 120 degrees of flexion.</p> <p>Results</p> <p>During deep knee flexion, in the anterior region of interest, the average Von Mises stress with the Journey PFJ design was comparable to the physiological knee, while reduced by almost 25% for both the Richards II design and the Genesis II total knee joint replacement design. The average Von Mises stress in the supracondylar region of interest was similar for both patellofemoral prosthetic designs and the physiological model, with slightly lower stress for the Genesis II design.</p> <p>Conclusions</p> <p>Patellofemoral joint replacement results in periprosthetic stress-shielding, although to a smaller degree than in total knee replacement. Specific patellofemoral prosthetic design properties may result in differences in femoral stress shielding.</p>http://www.josr-online.com/content/7/1/28Patellofemoral joint replacementKnee prosthesisFinite element analysisStress shieldingSquat movement |
| spellingShingle | van Jonbergen Hans-Peter W Innocenti Bernardo Gervasi Gian Labey Luc Verdonschot Nico Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study Journal of Orthopaedic Surgery and Research Patellofemoral joint replacement Knee prosthesis Finite element analysis Stress shielding Squat movement |
| title | Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study |
| title_full | Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study |
| title_fullStr | Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study |
| title_full_unstemmed | Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study |
| title_short | Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study |
| title_sort | differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement a finite element study |
| topic | Patellofemoral joint replacement Knee prosthesis Finite element analysis Stress shielding Squat movement |
| url | http://www.josr-online.com/content/7/1/28 |
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