title: Biomechanical background and clinical observations of rotational malalignment in TKA: literature review and consequences.
abstract: Malalignment, in particular femoral component malrotation, is a commonly accepted failure mode in total knee arthroplasty. The general objective of this paper is twofold: firstly, it accentuates clinical observations of the effects of rotational malalignment in total knee arthroplasty. Secondly, it discusses the relevant parameters of existing knee joint models with regards to rotational malalignment and its biomechanical background, thereby setting a basis for future studies. To summarise, when modelling malalignment in total knee arthroplasty, the following aspects should be considered: Friction between the implant components, ligamentous and capsular structures, deformable body to model the PE inlay, and an in vivo validation of the model. Because of the large variance in anthropometrical data between individuals, future knee joint models should also incorporate individual data.
authors.affiliation: Laboratory for Biomechanics, Swiss Federal Institute of Technology, 8093 Zurich, Switzerland. Zihlmann@biomech.mat.ethz.ch
authors.forename: Monika Silvia
authors.initials: MS
authors.lastname: Zihlmann
authors.forename: Alex
authors.initials: A
authors.lastname: Stacoff
authors.forename: José
authors.initials: J
authors.lastname: Romero
authors.forename: Inès Kramers-de
authors.initials: IK
authors.lastname: Quervain
authors.forename: Edgar
authors.initials: E
authors.lastname: Stüssi
mesh_terms: D000818:Animals; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D001696:Biomechanical Phenomena / Q000379:methods; D017760:Bone Malalignment / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D019544:Equipment Failure Analysis / Q000379:methods; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery*; D007720:Knee Prosthesis / Q000009:adverse effects*; D008954:Models, Biological; D009068:Movement; D011475:Prosthesis Failure; D012399:Rotation; D013314:Stress, Mechanical; D025321:Surgery, Computer-Assisted / Q000379:methods; D019415:Torque