Decreased ratios of lateral to medial patellofemoral forces and pressures after lateral retinacular release and gender knees in total knee arthroplasty

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• 作者：Joseph J. King III (1)
  Rajit Chakravarty (1)
  Douglas L. Cerynik (1)
  Aaron Black (1)
  Norman A. Johanson (1)
  
• 关键词：Patellofemoral contact pressure ; Total knee arthroplasty ; Patellar tracking ; Lateral release ; Gender knee
• 刊名：Knee Surgery, Sports Traumatology, Arthroscopy
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：21
• 期：12
• 页码：2770-2778
• 全文大小：
• 作者单位：Joseph J. King III (1)
  Rajit Chakravarty (1)
  Douglas L. Cerynik (1)
  Aaron Black (1)
  Norman A. Johanson (1)
  
  1. Department of Orthopaedic Surgery, Drexel University College of Medicine, 215 North Broad Street, MS 420, Philadelphia, PA, 19106, USA
  
• ISSN：1433-7347

文摘

Purpose To demonstrate that lateral to medial patellofemoral force and pressure ratios could be a surrogate marker of retinacular tension and patellar tracking. Methods The patellofemoral forces of six knees from three fresh-frozen half-body female cadavers were evaluated with a capacitive sensor under simulated operative conditions in six staged clinical scenarios: native knees, knee arthroplasty without patellar resurfacing, resurfaced knee and patella, resurfaced knee and patella with lateral release, gender-specific knee arthroplasty with patella resurfacing, and gender-specific knee arthroplasty with lateral release. Maximum force and peak pressure were simultaneously recorded during three to four ranges of motion. Average values were compared between lateral and medial patellofemoral compartments as an objective measure of patellar tracking for the different settings. Results Significant differences in lateral and medial force and pressure differentials were seen in most scenarios despite clinically normal patellar tracking. Lateral to medial ratios of maximum force and peak pressure significantly increased after TKA (2.9, 2.1) and after patella resurfacing (2.8, 2.6) compared to the native knee (1.6, 1.8). Addition of a lateral release in resurfaced knees decreased the ratio of lateral to medial patellofemoral forces and pressures as did gender knee arthroplasty (1.5 and 1.1, 2 and 1.3, respectively). Pressure and force values most closely resembled the native knee in the resurfaced knee/resurfaced patella with lateral release and in the gender knee arthroplasty scenarios. Conclusions Use of lateral to medial patellofemoral force ratios as a surrogate objective marker for patellar tracking was validated in this study by decreasing ratios observed after lateral release in TKA and with gender-specific implants.