Musculoskeletal Multibody Simulation Analysis on the Impact of Patellar Component Design and Positioning on Joint Dynamics after Unconstrained Total Knee Arthroplasty
Patellofemoral (PF) disorders are considered a major clinical complication after total knee replacement (TKR). Malpositioning and design of the patellar component impacts knee joint dynamics, implant fixation and wear propagation. However, only a limited number of studies have addressed the biomecha...
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doaj-a19f4974f9ba4dcab80b4c61169fd6022020-11-25T03:06:13ZengMDPI AGMaterials1996-19442020-05-01132365236510.3390/ma13102365Musculoskeletal Multibody Simulation Analysis on the Impact of Patellar Component Design and Positioning on Joint Dynamics after Unconstrained Total Knee ArthroplastyMaeruan Kebbach0Martin Darowski1Sven Krueger2Christoph Schilling3Thomas M. Grupp4Rainer Bader5Andreas Geier6Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, Rostock University Medical Center, 18057 Rostock, GermanyBiomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, Rostock University Medical Center, 18057 Rostock, GermanyAesculap AG Research and Development, 78532 Tuttlingen, GermanyAesculap AG Research and Development, 78532 Tuttlingen, GermanyAesculap AG Research and Development, 78532 Tuttlingen, GermanyBiomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, Rostock University Medical Center, 18057 Rostock, GermanyBiomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, Rostock University Medical Center, 18057 Rostock, GermanyPatellofemoral (PF) disorders are considered a major clinical complication after total knee replacement (TKR). Malpositioning and design of the patellar component impacts knee joint dynamics, implant fixation and wear propagation. However, only a limited number of studies have addressed the biomechanical impact of the patellar component on PF dynamics and their results have been discussed controversially. To address these issues, we implemented a musculoskeletal multibody simulation (MMBS) study for the systematical analysis of the patellar component’s thickness and positioning on PF contact forces and kinematics during dynamic squat motion with virtually implanted unconstrained cruciate-retaining (CR)-TKR. The patellar button thickness clearly increased the contact forces in the PF joint (up to 27%). Similarly, the PF contact forces were affected by superior–inferior positioning (up to 16%) and mediolateral positioning (up to 8%) of the patellar button. PF kinematics was mostly affected by the mediolateral positioning and the thickness of the patellar component. A medialization of 3 mm caused a lateral patellar shift by up to 2.7 mm and lateral patellar tilt by up to 1.6°. However, deviations in the rotational positioning of the patellar button had minor effects on PF dynamics. Aiming at an optimal intraoperative patellar component alignment, the orthopedic surgeon should pay close attention to the patellar component thickness in combination with its mediolateral and superior–inferior positioning on the retropatellar surface. Our generated MMBS model provides systematic and reproducible insight into the effects of patellar component positioning and design on PF dynamics and has the potential to serve as a preoperative analysis tool.https://www.mdpi.com/1996-1944/13/10/2365joint replacementknee jointtotal knee arthroplastypatellar componentmusculoskeletal multibody simulationpatellofemoral joint |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Maeruan Kebbach Martin Darowski Sven Krueger Christoph Schilling Thomas M. Grupp Rainer Bader Andreas Geier |
spellingShingle |
Maeruan Kebbach Martin Darowski Sven Krueger Christoph Schilling Thomas M. Grupp Rainer Bader Andreas Geier Musculoskeletal Multibody Simulation Analysis on the Impact of Patellar Component Design and Positioning on Joint Dynamics after Unconstrained Total Knee Arthroplasty Materials joint replacement knee joint total knee arthroplasty patellar component musculoskeletal multibody simulation patellofemoral joint |
author_facet |
Maeruan Kebbach Martin Darowski Sven Krueger Christoph Schilling Thomas M. Grupp Rainer Bader Andreas Geier |
author_sort |
Maeruan Kebbach |
title |
Musculoskeletal Multibody Simulation Analysis on the Impact of Patellar Component Design and Positioning on Joint Dynamics after Unconstrained Total Knee Arthroplasty |
title_short |
Musculoskeletal Multibody Simulation Analysis on the Impact of Patellar Component Design and Positioning on Joint Dynamics after Unconstrained Total Knee Arthroplasty |
title_full |
Musculoskeletal Multibody Simulation Analysis on the Impact of Patellar Component Design and Positioning on Joint Dynamics after Unconstrained Total Knee Arthroplasty |
title_fullStr |
Musculoskeletal Multibody Simulation Analysis on the Impact of Patellar Component Design and Positioning on Joint Dynamics after Unconstrained Total Knee Arthroplasty |
title_full_unstemmed |
Musculoskeletal Multibody Simulation Analysis on the Impact of Patellar Component Design and Positioning on Joint Dynamics after Unconstrained Total Knee Arthroplasty |
title_sort |
musculoskeletal multibody simulation analysis on the impact of patellar component design and positioning on joint dynamics after unconstrained total knee arthroplasty |
publisher |
MDPI AG |
series |
Materials |
issn |
1996-1944 |
publishDate |
2020-05-01 |
description |
Patellofemoral (PF) disorders are considered a major clinical complication after total knee replacement (TKR). Malpositioning and design of the patellar component impacts knee joint dynamics, implant fixation and wear propagation. However, only a limited number of studies have addressed the biomechanical impact of the patellar component on PF dynamics and their results have been discussed controversially. To address these issues, we implemented a musculoskeletal multibody simulation (MMBS) study for the systematical analysis of the patellar component’s thickness and positioning on PF contact forces and kinematics during dynamic squat motion with virtually implanted unconstrained cruciate-retaining (CR)-TKR. The patellar button thickness clearly increased the contact forces in the PF joint (up to 27%). Similarly, the PF contact forces were affected by superior–inferior positioning (up to 16%) and mediolateral positioning (up to 8%) of the patellar button. PF kinematics was mostly affected by the mediolateral positioning and the thickness of the patellar component. A medialization of 3 mm caused a lateral patellar shift by up to 2.7 mm and lateral patellar tilt by up to 1.6°. However, deviations in the rotational positioning of the patellar button had minor effects on PF dynamics. Aiming at an optimal intraoperative patellar component alignment, the orthopedic surgeon should pay close attention to the patellar component thickness in combination with its mediolateral and superior–inferior positioning on the retropatellar surface. Our generated MMBS model provides systematic and reproducible insight into the effects of patellar component positioning and design on PF dynamics and has the potential to serve as a preoperative analysis tool. |
topic |
joint replacement knee joint total knee arthroplasty patellar component musculoskeletal multibody simulation patellofemoral joint |
url |
https://www.mdpi.com/1996-1944/13/10/2365 |
work_keys_str_mv |
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