Effect of Patellar Tendon Shortening on Tracking of the Patella

Background Although 10% postoperative patellar tendon shortening after bone–patellar tendon–bone autograft reconstruction of the anterior cruciate ligament has been reported, there are no published studies assessing the effect of shortening on patellofemoral joint biomechanics under physiological loading conditions. Purpose To investigate the influence of patellar tendon shortening on patellofemoral joint biomechanics. Study Design Controlled laboratory study. Methods The authors evaluated the patellofemoral contact area, the location of contact, and the patellofemoral joint reaction force and contact stresses in 7 cadaveric knees before and after 10% patellar tendon shortening. Shortening was achieved using a specially designed device. Experimental conditions simulating those occurring during level walking were employed: physiological quadriceps loads and corresponding angles of tibial rotation were applied at 15 °, 30 °, and 60 ° flexion of the knee. Patellofemoral joint contact areas were measured before and after shortening using the silicone oil–carbon black powder suspension squeeze technique. Results After patellar tendon shortening, patellofemoral joint contact areas were displaced proximally on the patellar surface and distally on the femoral surface. Although the contact area increased by 18% at 15 ° of knee flexion (P=. 04), no significant change occurred at 30 ° or 60 ° of knee flexion (P>. 05). Patellofemoral contact stress remained unchanged after patellar tendon shortening (P>. 05) at each flexion angle. Conclusion Our results suggest that a 10% shortening of the patellar tendon does not alter patellar contact stresses during locomotion. It is not clear whether apparent changes in contact location in all positions and contact area at 15 ° would have clinical consequences.

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Validation of an MRI-based method to assess patellofemoral joint contact areas in loaded knee flexion in vivo

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.24240 ◽

2013 ◽

Vol 39 (4) ◽

pp. 978-987 ◽

Cited By ~ 4

Author(s):

Emily J. McWalter ◽

Colm M. O'Kane ◽

David P. FitzPatrick ◽

David R. Wilson

Keyword(s):

Knee Flexion ◽

Patellofemoral Joint ◽

Contact Areas ◽

Joint Contact

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In Vivo Kinematics of the Extensor Mechanism of the Knee During Deep Flexion

Journal of Biomechanical Engineering ◽

10.1115/1.4024284 ◽

2013 ◽

Vol 135 (8) ◽

Cited By ~ 5

Author(s):

Koichi Kobayashi ◽

Ali Hosseini ◽

Makoto Sakamoto ◽

Wei Qi ◽

Harry E. Rubash ◽

...

Keyword(s):

Patellar Tendon ◽

Knee Flexion ◽

Extensor Mechanism ◽

Deep Flexion ◽

Contact Points ◽

Patellar Cartilage ◽

Joint Contact ◽

Joint Biomechanics ◽

Few Data

While various factors have been assumed to affect knee joint biomechanics, few data have been reported on the function of the extensor mechanism in deep flexion of the knee. This study analyzed the patellofemoral joint contact kinematics and the ratio of the quadriceps and patellar tendon forces in living subjects when they performed a single leg lunge up to 150 deg of flexion. The data revealed that in the proximal-distal direction, the patellofemoral articular contact points were in the central one-third of the patellar cartilage. Beyond 90 deg of flexion, the contact points moved towards the medial-lateral edges of the patellar surface. At low flexion angles, the patellar tendon and quadriceps force ratio was approximately 1.0 but reduced to about 0.7 after 60 deg of knee flexion, implying that the patella tendon carries lower loads than the quadriceps. These data may be valuable for improvement of contemporary surgical treatments of diseased knees that are aimed to achieve deep knee flexion.

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Patellofemoral joint contact area increases with knee flexion and weight-bearing

Journal of Orthopaedic Research® ◽

10.1016/j.orthres.2004.08.003 ◽

2005 ◽

Vol 23 (2) ◽

pp. 345-350 ◽

Cited By ~ 135

Author(s):

Thor F. Besier ◽

Christine E. Draper ◽

Garry E. Gold ◽

Gary S. Beaupré ◽

Scott L. Delp

Keyword(s):

Contact Area ◽

Knee Flexion ◽

Patellofemoral Joint ◽

Weight Bearing ◽

Joint Contact

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Trochlear Contact Pressures after Straight Anteriorization of the Tibial Tuberosity

The American Journal of Sports Medicine ◽

10.1177/0363546508317125 ◽

2008 ◽

Vol 36 (10) ◽

pp. 1953-1959 ◽

Cited By ~ 42

Author(s):

John-Paul H. Rue ◽

Anne Colton ◽

Stephanie M. Zare ◽

Elizabeth Shewman ◽

Jack Farr ◽

...

Keyword(s):

Contact Area ◽

Clinical Relevance ◽

Knee Flexion ◽

Patellofemoral Joint ◽

Pressure Sensors ◽

Contact Forces ◽

Tibial Tuberosity ◽

Before And After ◽

The Mean ◽

Contact Pressures

Background Anteromedialization of the tibial tuberosity has been shown to decrease mean total contact pressures of the lateral trochlea and to shift contact pressures to the medial trochlea. Hypothesis Modifying the anteromedialization osteotomy to a straight anteriorization osteotomy of the tibial tuberosity can decrease trochlear contact pressures without a resultant medial shift of forces to the medial trochlear contact area. Study Design Controlled laboratory study. Methods Ten cadavers were tested before and after straight anteriorization tibial tuberosity osteotomy by loading the extensor mechanism with 89.1 and 178.2 N at 0°, 30°, 60°, and 90° of flexion following a validated patellofemoral joint loading protocol. Contact pressures were measured with electroresistive pressure sensors placed directly on the trochlea. Results The mean trochlear contact pressures after osteotomy decreased significantly ( P < .05) for loads of 89.1 and 178.2 N at both 30° (23% and 20%, respectively) and 60° (18.7% and 31.9%, respectively) of knee flexion. The peak contact pressures decreased significantly ( P < .05) for loads of 89.1 and 178.2 N at 30° (24.3% and 27.0%, respectively) and 60° (31.9% and 24.5%, respectively) and for loads of 89.1 N at 90° (13.4%) of knee flexion. Conclusion The authors demonstrated significantly decreased trochlear contact forces after straight anteriorization osteotomy of the tibial tuberosity, without a significant resultant medial shift of the center of force. Clinical Relevance Straight anteriorization of the tibial tuberosity may be a useful adjunct for patients with medial articular defects of the patellar or trochlea in whom anteromedialization would be otherwise contraindicated.

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Patellofemoral Joint Contact Area Is Influenced by Tibiofemoral Rotation Alignment in Individuals Who Have Patellofemoral Pain

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.2007.37.9.521 ◽

2007 ◽

Vol 37 (9) ◽

pp. 521-528 ◽

Cited By ~ 83

Author(s):

Gretchen B. Salsich ◽

William H. Perman

Keyword(s):

Contact Area ◽

Patellofemoral Joint ◽

Patellofemoral Pain ◽

Tibiofemoral Rotation ◽

Joint Contact

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Load-Bearing at the Meniscofemoral Joint: An in vitro Study in the Canine Knee

The Duke Orthopaedic Journal ◽

10.5005/jp-journals-10017-1006 ◽

2011 ◽

Vol 1 (1) ◽

pp. 39-43 ◽

Cited By ~ 1

Author(s):

Pier Francesco Indelli ◽

John A Szivek ◽

Andrew Schnepp ◽

William A Grana

Keyword(s):

Contact Stress ◽

Contact Area ◽

Knee Flexion ◽

Femoral Condyle ◽

Testing Machine ◽

Partial Meniscectomy ◽

Clinical Value ◽

Contact Areas ◽

Local Contact ◽

Femoral Condyles

ABSTRACT Background The role of the menisci on tibial load transmission and stress distribution has been extensively studied, but few studies have focused on the meniscofemoral joint during physiologic weightbearing. The objective of this study was to determine the contact areas and local contact stresses at the meniscofemoral interface during physiologic range of motion and axial-loading in the canine knee and to determine the influence of a partial or total meniscectomy. Methods Both fresh-frozen knees of 3 hound-type canines were tested in a universal testing machine configured for an axial-load of 90-120 N. Measurement of the contact area and the local contact stress were done at three different knee angles (30; 50; 70) and with both menisci intact, after partial meniscectomy, and after total meniscectomy. Pressure distribution was estimated by using pressure sensitive film inserted above the menisci. Results After partial meniscectomy, contact areas at 50° of knee flexion decreased approximately 25% on both femoral condyles, and local contact stress increased 30% on the medial femoral condyle but remained unchanged on the lateral. After total meniscectomy, contact areas at 50° of knee flexion decreased approximately 75% on both femoral condyles, and local contact stress increased approximately 60% on the medial compartment and 100% on the lateral compartment. Conclusions These data suggest that a conservative partial meniscectomy leaves the meniscus with an inferior weight distribution function; decreasing, but not canceling the protection on the femoral hyaline cartilage. A dramatic decrease of contact area followed by an increase of local contact stress was noted after a total meniscectomy. The clinical value of this study is to emphasize the biomechanical value of surgical procedures addressing the repair of damaged menisci.

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Changes in Wrist Joint Contact Area Following Radial Shortening Osteotomy for Kienböck Disease

10.21203/rs.3.rs-907462/v1 ◽

2021 ◽

Author(s):

Junki Shiota ◽

Daisuke Momma ◽

Yuichiro Matsui ◽

Nozomu Inoue ◽

Eiji Kondo ◽

...

Keyword(s):

Contact Area ◽

Wrist Joint ◽

Articular Surface ◽

Shortening Osteotomy ◽

Before And After ◽

Reconstruction Software ◽

Joint Contact ◽

Kienböck Disease ◽

Analytical Program

Abstract We hypothesized that the contact area of the articular surface of the wrist joint could be evaluated using a custom-designed analytical program. The aim of the study was to compare the articular contact area of the wrist joint before and after radial shortening osteotomy for Kienböck disease. Nine wrists of 9 patients underwent radial shortening osteotomy for Kienböck disease. Computed tomography (CT) images of the wrist joint were reconstructed using a 3D reconstruction software package. Radioscaphoid and radiolunate joint contact areas and translation of the joint contact area from preoperative to postoperative were calculated using customized software. All patients reported a marked reduction of wrist pain at the 12-month follow-up. The contact area was altered following radial shortening, and the center of the contact area was translated radially and dorsally postoperatively. CT-based analysis revealed that the center of the contact area translated radially following radial shortening.

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