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

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

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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Acknowledgments

This research was supported in part by Grants-in-aid for a Regional R&D Proposal-Based Program from the Northern Advancement Center for Science and Technology of Hokkaido, Japan.

Conflict of interest

The authors declared the following potential conflict of interest with respect to the research, authorship, and/or publication of this article: Tokifumi Majima is a speaker bureau/paid presenter for Depuy Japan and Smith and Nephew. Tokifumi Majima acted as a consultant for Robert Reid Inc. No authors will receive royalties related to this product.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-Ku, Sapporo, 060-8638, Japan

    Takashi Terashima, Tomohiro Onodera, Naohiro Sawaguchi & Yasuhiko Kasahara

  2. Department of Orthopedic Surgery, International University of Health and Welfare Hospital, 537-8, Iguchi, Nasushiobara, 329-2763, Japan

    Tokifumi Majima

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  1. Takashi Terashima
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  2. Tomohiro Onodera
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  3. Naohiro Sawaguchi
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Correspondence to Tokifumi Majima.

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

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  • DOI: https://doi.org/10.1007/s00167-014-3103-5

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