Related Experiment Videos
Computer simulations of patellofemoral joint surgery. Patient-specific models for tuberosity transfer
Zohara A Cohen1, Jack H Henry, Denise M McCarthy
1Department of Mechanical Engineering and Biomedical Engineering, Columbia University, New York, New York, USA.
Background:
Variable clinical outcomes of tibial tuberosity transfer surgery have been reported.
Hypotheses:
The biomechanical outcome of surgery is patient-specific; no single procedure produces superior results for all patients. Use of patient-specific computer models can optimize choice of procedure.
Study Design:
Computer simulation study using clinical data.
Methods:
We used patient-specific multibody models of the patellofemoral joints of 20 patients with a diagnosis of patellar subluxation and osteoarthritis. Four tibial tuberosity transfer procedures (two anterior and two anteromedial) were simulated for each patient and compared with their preoperative model.
Results:
When results for all patients were averaged, all simulated operations produced a statistically significant decrease in surface-wide mean contact stress, although no significant difference was found among them.
Conclusions:
The simulated surgical outcomes were patient-specific: no single procedure was consistently superior at decreasing peak or mean stress and each procedure produced a potentially detrimental outcome, an increase in either mean stress or peak stress, in at least one patient.
Clinical Relevance:
Computer simulation may serve as a valuable tool for tailoring procedures to specific patients.