title: Changes in sagittal component alignment alters patellar kinematics in TKA: an in vitro study.
abstract: OBJECTIVE
  Patellar maltracking due to incorrect component alignment is considered as a main reason for anterior knee pain after total knee arthroplasty (TKA). In contrast to coronal and axial component placement, the influence of sagittal component alignment on patellar kinematics has not been investigated so far.
  
  
  METHODS
  In ten lower cadaveric limbs, TKAs were implanted using a commercial computer navigation system. In six knees, the femoral component was aligned in 5° and in four knees in 0° of flexion, respectively. Patellar kinematics were registered by means of a computer navigation system using an additional patella tracking array and correlated with femoral and tibial sagittal component alignment.
  
  
  RESULTS
  Sagittal component alignment significantly altered patellar mediolateral shift (p < 0.05). In contrast, patellar epicondylar distance, rotation and tilt were not significantly influenced.
  
  
  CONCLUSIONS
  Sagittal component alignment in TKA has a major impact on patellar kinematics and should therefore be considered while addressing tibiofemoral kinematics intraoperatively.
authors.affiliation: Department of Orthopaedic Surgery, University of Regensburg, Kaiser-Karl-V Allee 3, 93077, Bad Abbach, Germany. keshmiri_armin@yahoo.de.
authors.forename: Armin
authors.initials: A
authors.lastname: Keshmiri
authors.affiliation: Department of Orthopaedic Surgery, University of Regensburg, Kaiser-Karl-V Allee 3, 93077, Bad Abbach, Germany.
authors.forename: Hans Robert
authors.initials: HR
authors.lastname: Springorum
authors.affiliation: Department of Orthopaedic Surgery, University of Regensburg, Kaiser-Karl-V Allee 3, 93077, Bad Abbach, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Baier
authors.affiliation: Centre for Clinical Studies, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Zeman
authors.affiliation: Department of Orthopaedic Surgery, University of Regensburg, Kaiser-Karl-V Allee 3, 93077, Bad Abbach, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Grifka
authors.affiliation: Department of Orthopaedic Surgery, University of Regensburg, Kaiser-Karl-V Allee 3, 93077, Bad Abbach, Germany.
authors.forename: Günther
authors.initials: G
authors.lastname: Maderbacher
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D001696:Biomechanical Phenomena / Q000502:physiology; D002102:Cadaver; D006801:Humans; D007720:Knee Prosthesis; D016014:Linear Models; D010329:Patella / Q000502:physiology*; D017755:Prosthesis Fitting; D025321:Surgery, Computer-Assisted
keywords: Computer navigation system; Patellar kinematics; Patellar tracking; Sagittal component alignment; Total knee arthroplasty
references.citation: Orthopade. 2003 Apr;32(4):312-8
references.pmid: 12707695
references.citation: Knee Surg Sports Traumatol Arthrosc. 2013 Oct;21(10 ):2271-80
references.pmid: 23948721
references.citation: Clin Orthop Relat Res. 2012 Jan;470(1):91-8
references.pmid: 21984353
references.citation: J Bone Joint Surg Am. 1989 Aug;71(7):1031-9
references.pmid: 2760078
references.citation: Clin J Sport Med. 1995;5(1):9-17
references.pmid: 7614086
references.citation: Clin Orthop Relat Res. 2011 Jan;469(1):10-7
references.pmid: 20706813
references.citation: Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2560-8
references.pmid: 25023661
references.citation: Clin Orthop Relat Res. 1988 Jan;(226):49-64
references.pmid: 3335107
references.citation: Clin Orthop Relat Res. 1983 Mar;(173):178-83
references.pmid: 6825330
references.citation: Clin Orthop Relat Res. 1998 Nov;(356):144-53
references.pmid: 9917679
references.citation: Clin Orthop Relat Res. 2004 Mar;(420):213-9
references.pmid: 15057100
references.citation: Clin Orthop Relat Res. 2001 Nov;(392):46-55
references.pmid: 11716424
references.citation: Orthopedics. 2007 Nov;30(11):965-7
references.pmid: 18019992
references.citation: Int Orthop. 2015 Mar;39(3):441-8
references.pmid: 25159011
references.citation: Knee Surg Sports Traumatol Arthrosc. 2010 Mar;18(3):381-7
references.pmid: 19924399
references.citation: J Bone Joint Surg Br. 1995 Nov;77(6):884-9
references.pmid: 7593100
references.citation: Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1719-27
references.pmid: 24408075
references.citation: Clin Orthop Relat Res. 1986 Apr;(205):93-9
references.pmid: 3698397
references.citation: Clin Orthop Relat Res. 1994 Feb;(299):31-43
references.pmid: 8119035
references.citation: Int Orthop. 2014 Feb;38(2):379-85
references.pmid: 24173677
references.citation: Clin Orthop Relat Res. 2001 Nov;(392):38-45
references.pmid: 11716411
references.citation: J Arthroplasty. 2006 Sep;21(6):809-13
references.pmid: 16950031
references.citation: J Orthop Res. 2011 Feb;29(2):223-31
references.pmid: 20857489
references.citation: Knee Surg Sports Traumatol Arthrosc. 2014 Mar;22(3):534-42
references.pmid: 23728417
references.citation: Int Orthop. 2014 Feb;38(2):243-9
references.pmid: 24126498
references.citation: Acta Orthop. 2015;86(4):444-50
references.pmid: 25582349
references.citation: Clin Orthop Relat Res. 1998 Nov;(356):47-57
references.pmid: 9917667
references.citation: Clin Orthop Relat Res. 1995 Dec;(321):28-31
references.pmid: 7497681
references.citation: J Arthroplasty. 2000 Dec;15(8):970-3
references.pmid: 11112189
references.citation: Acta Orthop. 2014 Sep;85(5):480-7
references.pmid: 25036719
references.citation: Knee Surg Sports Traumatol Arthrosc. 2014 Mar;22(3):694-702
references.pmid: 24271215
references.citation: Osteoarthritis Cartilage. 2011 Mar;19(3):287-94
references.pmid: 21172445
references.citation: Am J Sports Med. 2004 Mar;32(2):376-82
references.pmid: 14977661