PMU-Autor/inn/en
Augat PeterAbstract
BACKGROUND
Femoropatellar complications are one of the most common problems after total knee arthroplasty (TKA). However, the question of whether to resurface the patella remains controversial. Therefore, we evaluated the kinetics and the retropatellar contact characteristics of patella resurfacing with fixed and gliding surfaces.
Eight Thiel-embalmed cadaver knees were tested--first intact, then after TKA without patellar resurfacing, and finally with additional patellar resurfacing--while flexing the knee from 0° to 100°. We tested a fixed as well as a gliding patella surface. During the examination, quadriceps and hamstring forces were applied. The retropatellar pressure was determined with a special patella sensor, and the patellar kinetics were measured using an optical three-dimensional motion analysis system.
Resurfacing the patella caused a significant increase in retropatellar pressure and a significant decrease in retropatellar contact area. Using a fixed patella, the retropatellar pressure nearly quadrupled in higher flexion compared to the native patella. Furthermore, the lateral movement of the patella increased after TKA, especially after additional patellar resurfacing.
Resurfacing the patella routinely is not advised. When osteoarthritis of the patella is found, the gliding patella should be preferred.
Useful keywords (using NLM MeSH Indexing)
Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee/methods*
Biomechanical Phenomena
Cadaver
Humans
Kinetics
Knee Joint/physiopathology
Knee Joint/surgery*
Knee Prosthesis*
Patella/physiopathology
Patella/surgery*
Postoperative Complications/physiopathology
Postoperative Complications/surgery*
Range of Motion, Articular/physiology*
Reoperation
Surface Properties