Stress distribution of the patellofemoral joint in the anatomic V-shape and curved dome-shape femoral component: a comparison of resurfaced and unresurfaced patellae

Chang Hung Huang, Lin I. Hsu, Ting Kuo Chang, Tai Yuan Chuang, Shih Liang Shih, Yung Chang Lu, Chen Sheng Chen, Chun Hsiung Huang

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: Whether to resurface the patella in knee replacement remains a controversial issue. The geometrical design of the trochlear groove in the femoral component could play an important role in determining the stress distribution on the patellofemoral joint, but this has not been sufficiently reported on. This study attempted to determine the effect of implant design on contact mechanics by means of a finite element method.

Methods: Two designs, an anatomical V-shape design (VSD) and a dome-shape design (DSD), for the anterior trochlear surface in a contemporary femoral component were chosen for examining the contact characteristics. The use and absence of patella resurfacing was simulated. The stress and strain distribution on the patellar bone and the polyethylene component were calculated for comparison.

Results: Without patellar resurfacing, the maximal compressive strain in the patellar bone in the VSD model was about 20 % lower than the DSD model. On the other hand, with resurfacing, the maximal strain for the VSD model was 13.3 % greater than for DSD. Uneven stress distribution at the bone–implant interface was also noted for the two designs.

Conclusion: The femoral component with a V-shape trochlear groove reduced the compressive strain on the unresurfaced patella. If resurfacing the patella, the femoral component with a curved domed-shape design might reduce the strain in the remaining patellar bone. Uneven stress could occur at the bone–implant interface, so design modifications for improving fixation strength and medialization of the patellar button would be helpful in reducing the risk of peg fracture or loosening.

Level of evidence: III.

Original languageEnglish
JournalKnee Surgery, Sports Traumatology, Arthroscopy
DOIs
Publication statusPublished - 2017

Fingerprint

Patellofemoral Joint
Patella
Thigh
Bone and Bones
Polyethylene
Mechanics
Knee

Keywords

  • Contact characteristics
  • Knee replacement
  • Patellar resurfacing
  • Patellofemoral joint

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Stress distribution of the patellofemoral joint in the anatomic V-shape and curved dome-shape femoral component : a comparison of resurfaced and unresurfaced patellae. / Huang, Chang Hung; Hsu, Lin I.; Chang, Ting Kuo; Chuang, Tai Yuan; Shih, Shih Liang; Lu, Yung Chang; Chen, Chen Sheng; Huang, Chun Hsiung.

In: Knee Surgery, Sports Traumatology, Arthroscopy, 2017.

Research output: Contribution to journalArticle

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title = "Stress distribution of the patellofemoral joint in the anatomic V-shape and curved dome-shape femoral component: a comparison of resurfaced and unresurfaced patellae",
abstract = "Purpose: Whether to resurface the patella in knee replacement remains a controversial issue. The geometrical design of the trochlear groove in the femoral component could play an important role in determining the stress distribution on the patellofemoral joint, but this has not been sufficiently reported on. This study attempted to determine the effect of implant design on contact mechanics by means of a finite element method.Methods: Two designs, an anatomical V-shape design (VSD) and a dome-shape design (DSD), for the anterior trochlear surface in a contemporary femoral component were chosen for examining the contact characteristics. The use and absence of patella resurfacing was simulated. The stress and strain distribution on the patellar bone and the polyethylene component were calculated for comparison.Results: Without patellar resurfacing, the maximal compressive strain in the patellar bone in the VSD model was about 20 {\%} lower than the DSD model. On the other hand, with resurfacing, the maximal strain for the VSD model was 13.3 {\%} greater than for DSD. Uneven stress distribution at the bone–implant interface was also noted for the two designs.Conclusion: The femoral component with a V-shape trochlear groove reduced the compressive strain on the unresurfaced patella. If resurfacing the patella, the femoral component with a curved domed-shape design might reduce the strain in the remaining patellar bone. Uneven stress could occur at the bone–implant interface, so design modifications for improving fixation strength and medialization of the patellar button would be helpful in reducing the risk of peg fracture or loosening.Level of evidence: III.",
keywords = "Contact characteristics, Knee replacement, Patellar resurfacing, Patellofemoral joint",
author = "Huang, {Chang Hung} and Hsu, {Lin I.} and Chang, {Ting Kuo} and Chuang, {Tai Yuan} and Shih, {Shih Liang} and Lu, {Yung Chang} and Chen, {Chen Sheng} and Huang, {Chun Hsiung}",
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T2 - a comparison of resurfaced and unresurfaced patellae

AU - Huang, Chang Hung

AU - Hsu, Lin I.

AU - Chang, Ting Kuo

AU - Chuang, Tai Yuan

AU - Shih, Shih Liang

AU - Lu, Yung Chang

AU - Chen, Chen Sheng

AU - Huang, Chun Hsiung

PY - 2017

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N2 - Purpose: Whether to resurface the patella in knee replacement remains a controversial issue. The geometrical design of the trochlear groove in the femoral component could play an important role in determining the stress distribution on the patellofemoral joint, but this has not been sufficiently reported on. This study attempted to determine the effect of implant design on contact mechanics by means of a finite element method.Methods: Two designs, an anatomical V-shape design (VSD) and a dome-shape design (DSD), for the anterior trochlear surface in a contemporary femoral component were chosen for examining the contact characteristics. The use and absence of patella resurfacing was simulated. The stress and strain distribution on the patellar bone and the polyethylene component were calculated for comparison.Results: Without patellar resurfacing, the maximal compressive strain in the patellar bone in the VSD model was about 20 % lower than the DSD model. On the other hand, with resurfacing, the maximal strain for the VSD model was 13.3 % greater than for DSD. Uneven stress distribution at the bone–implant interface was also noted for the two designs.Conclusion: The femoral component with a V-shape trochlear groove reduced the compressive strain on the unresurfaced patella. If resurfacing the patella, the femoral component with a curved domed-shape design might reduce the strain in the remaining patellar bone. Uneven stress could occur at the bone–implant interface, so design modifications for improving fixation strength and medialization of the patellar button would be helpful in reducing the risk of peg fracture or loosening.Level of evidence: III.

AB - Purpose: Whether to resurface the patella in knee replacement remains a controversial issue. The geometrical design of the trochlear groove in the femoral component could play an important role in determining the stress distribution on the patellofemoral joint, but this has not been sufficiently reported on. This study attempted to determine the effect of implant design on contact mechanics by means of a finite element method.Methods: Two designs, an anatomical V-shape design (VSD) and a dome-shape design (DSD), for the anterior trochlear surface in a contemporary femoral component were chosen for examining the contact characteristics. The use and absence of patella resurfacing was simulated. The stress and strain distribution on the patellar bone and the polyethylene component were calculated for comparison.Results: Without patellar resurfacing, the maximal compressive strain in the patellar bone in the VSD model was about 20 % lower than the DSD model. On the other hand, with resurfacing, the maximal strain for the VSD model was 13.3 % greater than for DSD. Uneven stress distribution at the bone–implant interface was also noted for the two designs.Conclusion: The femoral component with a V-shape trochlear groove reduced the compressive strain on the unresurfaced patella. If resurfacing the patella, the femoral component with a curved domed-shape design might reduce the strain in the remaining patellar bone. Uneven stress could occur at the bone–implant interface, so design modifications for improving fixation strength and medialization of the patellar button would be helpful in reducing the risk of peg fracture or loosening.Level of evidence: III.

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KW - Knee replacement

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