title: The influence of malrotation of the femoral component in total knee replacement on the mechanics of patellofemoral contact during gait: an in vitro biomechanical study.
abstract: Malrotation of the femoral component is a cause of patellofemoral maltracking after total knee arthroplasty. Its precise effect on the patellofemoral mechanics has not been well quantified. We have developed an in vitro method to measure the influence of patellar maltracking on contact. Maltracking was induced by progressively rotating the femoral component either internally or externally. The contact mechanics were analysed using Tekscan. The results showed that excessive malrotation of the femoral component, both internally and externally, had a significant influence on the mechanics of contact. The contact area decreased with progressive maltracking, with a concomitant increase in contact pressure. The amount of contact area that carries more than the yield stress of ultra-high molecular weight polyethylene significantly increases with progressive maltracking. It is likely that the elevated pressures noted in malrotation could cause accelerated and excessive wear of the patellar button.
authors.affiliation: Department of Orthopaedics University Hospital Leuven, Weligerveld 1, 3212 Pellenberg, Lubbeek, Belgium. Chr.verlinden@gmail.com
authors.forename: C
authors.initials: C
authors.lastname: Verlinden
authors.forename: P
authors.initials: P
authors.lastname: Uvin
authors.forename: L
authors.initials: L
authors.lastname: Labey
authors.forename: J P
authors.initials: JP
authors.lastname: Luyckx
authors.forename: J
authors.initials: J
authors.lastname: Bellemans
authors.forename: H
authors.initials: H
authors.lastname: Vandenneucker
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001696:Biomechanical Phenomena; D003198:Computer Simulation; D005684:Gait / Q000502:physiology*; D006801:Humans; D007720:Knee Prosthesis; D008953:Models, Anatomic; D057071:Patellofemoral Joint / Q000473:pathology / Q000503:physiopathology*; D011475:Prosthesis Failure; D012399:Rotation / Q000009:adverse effects*; D013314:Stress, Mechanical; D013499:Surface Properties; D016474:Weight-Bearing