Differences between native and prosthetic knees in terms of cross-sectional morphology of the femoral trochlea: a study based on three-dimensional models and virtual total knee arthroplasty
Abstract Background The cross-sectional morphology of the prosthetic knee is crucial to understanding patellar motion and quadriceps strength after total knee arthroplasty. However, few comparative evaluations of the cross-sectional morphology of the femoral trochlea have been performed in the nativ...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-04-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-017-1529-x |
| _version_ | 1811214948908400640 |
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| author | Zhe Du Shichang Chen Mengning Yan Bing Yue You Wang |
| author_facet | Zhe Du Shichang Chen Mengning Yan Bing Yue You Wang |
| author_sort | Zhe Du |
| collection | DOAJ |
| description | Abstract Background The cross-sectional morphology of the prosthetic knee is crucial to understanding patellar motion and quadriceps strength after total knee arthroplasty. However, few comparative evaluations of the cross-sectional morphology of the femoral trochlea have been performed in the native knee and currently available femoral implants, and the relationship between the trochlear anatomy of prosthetic components and post-operative patellofemoral complications remains unclear. We aimed to investigate the differences in cross-sectional morphology of the femoral trochlea between native knees and prosthetic femoral components. Methods Virtual total knee arthroplasty was performed, whereby four different femoral components (medial-pivot, Triathlon, NRG and NexGen) were virtually superimposed onto three-dimensional models of 42 healthy femurs. The following morphological parameters were measured in three cross-sections (0, 45 and 90°) of the femoral trochlea: sulcus height, lateral tilt angle, medial tilt angle and sulcus angle. Only statistically significant differences are described further (p < 0.05). Results In the 0° cross-section, sulcus height was smaller in the native knee than in the Triathlon, NRG and NexGen components; all prosthetic components had smaller lateral tilt angles and larger medial tilt angles. In the 45° cross-section, sulcus height was larger in the native knee than in the medial-pivot, Triathlon and NexGen components; both lateral and medial tilt angles were smaller in the prosthetic components. In the 90° cross-section, sulcus height was smaller in the native knee than in the medial-pivot component; all prosthetic components had a larger lateral tilt angle and smaller medial tilt angle. In all cross-sections, the sulcus angle was smaller in the native knee. Conclusions The discrepancy between native and prosthetic trochlear geometries suggests altered knee mechanics after total knee arthroplasty, but further cadaveric, computational or fluoroscopic investigations are necessary to clarify the implications of this observation. Our findings can be used to optimize biomechanical guidelines for total knee arthroplasty (patellar resurfacing or non-resurfacing) in Chinese individuals so as to decrease the risk of patellar lateral dislocation, to maintain stability and to optimize extensor kinematics. |
| first_indexed | 2024-04-12T06:14:09Z |
| format | Article |
| id | doaj.art-bb65386f2b634635aaa761351a3feade |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-12T06:14:09Z |
| publishDate | 2017-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-bb65386f2b634635aaa761351a3feade2022-12-22T03:44:35ZengBMCBMC Musculoskeletal Disorders1471-24742017-04-011811810.1186/s12891-017-1529-xDifferences between native and prosthetic knees in terms of cross-sectional morphology of the femoral trochlea: a study based on three-dimensional models and virtual total knee arthroplastyZhe Du0Shichang Chen1Mengning Yan2Bing Yue3You Wang4Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong UniversityDepartment of Orthopaedic Surgery, Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Orthopaedic Surgery, Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong UniversityDepartment of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong UniversityAbstract Background The cross-sectional morphology of the prosthetic knee is crucial to understanding patellar motion and quadriceps strength after total knee arthroplasty. However, few comparative evaluations of the cross-sectional morphology of the femoral trochlea have been performed in the native knee and currently available femoral implants, and the relationship between the trochlear anatomy of prosthetic components and post-operative patellofemoral complications remains unclear. We aimed to investigate the differences in cross-sectional morphology of the femoral trochlea between native knees and prosthetic femoral components. Methods Virtual total knee arthroplasty was performed, whereby four different femoral components (medial-pivot, Triathlon, NRG and NexGen) were virtually superimposed onto three-dimensional models of 42 healthy femurs. The following morphological parameters were measured in three cross-sections (0, 45 and 90°) of the femoral trochlea: sulcus height, lateral tilt angle, medial tilt angle and sulcus angle. Only statistically significant differences are described further (p < 0.05). Results In the 0° cross-section, sulcus height was smaller in the native knee than in the Triathlon, NRG and NexGen components; all prosthetic components had smaller lateral tilt angles and larger medial tilt angles. In the 45° cross-section, sulcus height was larger in the native knee than in the medial-pivot, Triathlon and NexGen components; both lateral and medial tilt angles were smaller in the prosthetic components. In the 90° cross-section, sulcus height was smaller in the native knee than in the medial-pivot component; all prosthetic components had a larger lateral tilt angle and smaller medial tilt angle. In all cross-sections, the sulcus angle was smaller in the native knee. Conclusions The discrepancy between native and prosthetic trochlear geometries suggests altered knee mechanics after total knee arthroplasty, but further cadaveric, computational or fluoroscopic investigations are necessary to clarify the implications of this observation. Our findings can be used to optimize biomechanical guidelines for total knee arthroplasty (patellar resurfacing or non-resurfacing) in Chinese individuals so as to decrease the risk of patellar lateral dislocation, to maintain stability and to optimize extensor kinematics.http://link.springer.com/article/10.1186/s12891-017-1529-xTotal knee arthroplastyFemoral trochleaMorphologyProsthesis design |
| spellingShingle | Zhe Du Shichang Chen Mengning Yan Bing Yue You Wang Differences between native and prosthetic knees in terms of cross-sectional morphology of the femoral trochlea: a study based on three-dimensional models and virtual total knee arthroplasty BMC Musculoskeletal Disorders Total knee arthroplasty Femoral trochlea Morphology Prosthesis design |
| title | Differences between native and prosthetic knees in terms of cross-sectional morphology of the femoral trochlea: a study based on three-dimensional models and virtual total knee arthroplasty |
| title_full | Differences between native and prosthetic knees in terms of cross-sectional morphology of the femoral trochlea: a study based on three-dimensional models and virtual total knee arthroplasty |
| title_fullStr | Differences between native and prosthetic knees in terms of cross-sectional morphology of the femoral trochlea: a study based on three-dimensional models and virtual total knee arthroplasty |
| title_full_unstemmed | Differences between native and prosthetic knees in terms of cross-sectional morphology of the femoral trochlea: a study based on three-dimensional models and virtual total knee arthroplasty |
| title_short | Differences between native and prosthetic knees in terms of cross-sectional morphology of the femoral trochlea: a study based on three-dimensional models and virtual total knee arthroplasty |
| title_sort | differences between native and prosthetic knees in terms of cross sectional morphology of the femoral trochlea a study based on three dimensional models and virtual total knee arthroplasty |
| topic | Total knee arthroplasty Femoral trochlea Morphology Prosthesis design |
| url | http://link.springer.com/article/10.1186/s12891-017-1529-x |
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