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Asymmetrical total knee arthroplasty does not improve patella tracking: a study without patella resurfacing
Marco Barink1, Huub Meijerink, Nico Verdonschot
1Orthopaedic Research Laboratory, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
Summary
Total knee arthroplasty (TKA) significantly alters natural knee movement and patella tracking. Asymmetrical TKA designs do not offer improved patella tracking compared to symmetrical designs.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Biomedical Engineering
Background:
- Patella tracking is crucial for knee function after total knee arthroplasty (TKA).
- The hypothesis that asymmetrical patella grooves improve patella tracking post-TKA remains debated.
Purpose of the Study:
- To investigate the impact of TKA on patella tracking.
- To compare patella tracking in asymmetrical versus symmetrical TKA designs.
Main Methods:
- Kinematic analysis of five cadaveric knee specimens in intact, zipper, symmetrical TKA, and asymmetrical TKA states.
- Measurement of patellar and tibial kinematics, including medio-lateral translation, tilt, and tibial rotation.
- Assessment of tibio-femoral and patello-femoral joint motion envelopes under tibial moments.
Main Results:
- Total knee arthroplasty (TKA) caused statistically significant alterations in patellar medio-lateral translation, patellar tilt, and tibial rotation compared to the intact state.
- No significant kinematic differences were observed between symmetrical and asymmetrical TKA configurations.
Conclusions:
- Conventional TKA significantly disrupts physiological patello-femoral kinematics.
- Asymmetrical patella groove designs in TKA do not enhance patella tracking compared to symmetrical designs.