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. 2019 Nov 28;14(1):400.
doi: 10.1186/s13018-019-1458-5.

Effect of Sagittal Femoral Component Alignment on Biomechanics After Mobile-Bearing Total Knee Arthroplasty

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Free PMC article

Effect of Sagittal Femoral Component Alignment on Biomechanics After Mobile-Bearing Total Knee Arthroplasty

Yong-Gon Koh et al. J Orthop Surg Res. .
Free PMC article

Abstract

Background: Recently, there has been increasing interest in mobile-bearing total knee arthroplasty (TKA). However, changes in biomechanics with respect to femoral component alignment in mobile-bearing TKA have not been explored in depth. This study aims to evaluate the biomechanical effect of sagittal alignment of the femoral component in mobile-bearing TKA.

Methods: We developed femoral sagittal alignment models with - 3°, 0°, 3°, 5°, and 7°. We also examined the kinematics of the tibiofemoral (TF) joint, contact point on the TF joint, contact stress on the patellofemoral (PF) joint, collateral ligament force, and quadriceps force using a validated computational model under a deep-knee-bend condition.

Results: Posterior kinematics of the TF joint increased as the femoral component flexed. In addition, contact stress on the PF joint, collateral ligament force, and quadriceps force decreased as the femoral component flexed. The results of this study can assist surgeons in assessing risk factors associated with femoral component sagittal alignment for mobile-bearing TKA.

Conclusions: Our results showed that slight flexion implantation may be an effective alternative technique because of its advantageous biomechanical effect. However, excessive flexion should be avoided because of potential loosening of the TF joint.

Keywords: Finite element analysis; Malalignment; Mobile-bearing; Total knee arthroplasty.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Methodology for ligament insertion points using magnetic resonance imaging when developing intact knee joint 3D model
Fig. 2
Fig. 2
Developed five mobile-bearing TKA models with a − 3°, b 0°, c 3°, d 5°, and e 7° of femoral component flexion in sagittal alignments
Fig. 3
Fig. 3
Comparison of AP translations in TF joint at 30° and 75° flexions between our computational model and previous experiment for validation of mobile-bearing TKA model
Fig. 4
Fig. 4
Comparison of kinematic on TF joint with − 3°, 0°, 3°, 5°, and 7° of femoral component flexion models in deep-knee-bend loading condition
Fig. 5
Fig. 5
Contact point changes on TF joint with a− 3°, b 3°, and c 7° of femoral component flexion models at 0°, 30°, 60°, 90°, and 120° flexions
Fig. 6
Fig. 6
Comparison of contact stress on PF joint with − 3°, 0°, 3°, 5°, and 7° of femoral component flexion models in deep-knee-bend loading condition
Fig. 7
Fig. 7
Comparison of (a) medial and (b) lateral collateral ligament force with − 3°, 0°, 3°, 5°, and 7° of femoral component flexion models in deep-knee-bend loading condition
Fig. 8
Fig. 8
Comparison of quadriceps force with − 3°, 0°, 3°, 5°, and 7° of femoral component flexion models in deep-knee-bend loading condition

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