ArticleBiomedical engineering online2013
Patellofemoral contact patterns before and after total knee arthroplasty: an in vitro measurement.
Article in Biomedical engineering online, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 63 citations in OpenAlex.
- Dynamic computed tomography assessment of patellofemoral and tibiofemoral kinematics before and after total knee arthroplasty: A pilot study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Retropatellar resurfacing in primary total knee arthroplasty does not improve clinical outcomes but increases revision rates.Archives of orthopaedic and trauma surgery · 2026Observational
- [Update 2025: Biomechanics and kinematics after total knee arthroplasty (TKA)].Orthopadie (Heidelberg, Germany) · 2025Article
- Improved quadriceps efficiency with a medial pivot in comparison to a cruciate-retaining design in total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Conceptual foundations of a REFRAME-based approach to discriminate across total knee implant designs based on the positions of functional centres of rotation.Scientific reports · 2025Article
- The Influence of Kinematic Alignment on Patellofemoral Joint Biomechanics in Total Knee Arthroplasty.Journal of clinical medicine · 2024Article
- Modeling of the native knee with kinematic data derived from experiments using the VIVO™ joint simulator: a feasibility study.Biomedical engineering online · 2024Article
- Load-Dependent Characteristics of Cruciate-Retaining and Posterior-Stabilized Total Knee Arthroplasty: A Biomechanical Study.Clinics in orthopedic surgery · 2024Article
- Validation of Inertial-Measurement-Unit-Based Ex Vivo Knee Kinematics during a Loaded Squat before and after Reference-Frame-Orientation Optimisation.Sensors (Basel, Switzerland) · 2024Article
- Does Posterior Tibial Slope Influence Knee Kinematics in Medial Stabilized TKA?Journal of clinical medicine · 2022Article
- Deepening trochleoplasty may dramatically increase retropatellar contact pressures- a pilot study establishing a finite element model.Journal of experimental orthopaedics · 2022Article
- Intraoperative analysis of patellofemoral joint morphology before and after total knee arthroplasty : A feasibility study.Orthopadie (Heidelberg, Germany) · 2022Article
- In vivo articular contact pattern of a total wrist arthroplasty design.Journal of biomechanics · 2021Article
- Influence of Patella thickness on Patellofemoral pressure in total knee Arthroplasty.BMC musculoskeletal disorders · 2021Article
- Secondary Patellar Resurfacing in TKA: A Combined Analysis of Registry Data and Biomechanical Testing.Journal of clinical medicine · 2021Article
- Kinematic Comparison between Medially Congruent and Posterior-Stabilized Third-Generation TKA Designs.Journal of functional morphology and kinesiology · 2021Article
- The tibial cut influences the patellofemoral knee kinematics and pressure distribution in total knee arthroplasty with constitutional varus alignment.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- TKA design-integrated trochlea groove rotation reduces patellofemoral pressure.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Article
- Kinematically aligned total knee arthroplasty reproduces native patellofemoral biomechanics during deep knee flexion.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Article
- High wear resistance of femoral components coated with titanium nitride: a retrieval analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatellofemoral complications are one of the main problems after Total Knee Arthroplasty (TKA). Retropatellar pressure distribution after TKA can contribute to these symptoms. Therefore we evaluated retropatellar pressure distribution subdivided on the ridge, medial and lateral surface on non-resurfaced patella before and after TKA. Additionally, we analyzed axial femorotibial rotation and quadriceps load before and after TKA.
methodsSeven fresh frozen cadaver knees were tested in a force controlled knee rig before and after TKA (Aesculap, Tuttlingen, Germany, Columbus CR) while isokinetic flexing the knee from 20° to 120° under weight bearing. Ridge, medial and lateral retropatellar surface were defined and pressure distribution was dynamically measured while quadriceps muscles and hamstring forces were applied. Aside axial femorotibial rotation and quadriceps load was recorded.
resultsThere was a significant change of patella pressure distribution before and after TKA (p = 0.004). In physiological knees pressure distribution on medial and lateral retropatellar surface was similar. After TKA the ridge of the patella was especially in higher flexion grades strongly loaded (6.09 +/−1.31 MPa) compared to the natural knee (2.92 +/−1.15 MPa, p < 0.0001). Axial femorotibial rotation showed typical internal rotation with increasing flexion both before and after TKA, but postoperatively it was significantly lower. The average amount of axial rotation was 3.5° before and after TKA 1.3° (p = 0.001). Mean quadriceps loading after implantation of knee prosthesis did not change significantly (575 N ± 60 N in natural knee and after TKA 607 N ± 96 N; p = 0.28).
conclusionsThe increased retropatellar pressure especially on the ridge may be one important reason for anterior knee pain after TKA. The trochlea of the femoral component might highly influence the pressure distribution of the non-resurfaced retropatellar surface. Additionally, lower axial femorotibial rotation after TKA might lead to patella maltracking. Changing the design of the prosthesis or a special way of patella shaping might increase the conformity of the patella to trochlea to maintain natural contact patterns.
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