Patellofemoral instability in trochleodysplastic knee joints and the quantitative influence of simulated trochleoplasty - A finite element simulation
OPEN ACCESS
Loading...
Author / Producer
Date
2021-01
Publication Type
Journal Article
ETH Bibliography
yes
Citations
Altmetric
OPEN ACCESS
Data
Abstract
Background
Patellofemoral instability is a debilitating condition mainly affecting young patients and has been correlated with trochlear dysplasia. It can occur when the patella is insufficiently guided through its range of motion. Currently, there is no literature describing patellofemoral stability in trochleodysplastic knees and the effect of isolated trochleoplasty on patellofemoral stability.
Methods
The effect of isolated trochleoplasty in trochleodysplastic knees of patients with symptomatic patellofemoral instability was investigated using a quasi-static finite element model. MRI data of five healthy knees were segmented, meshed and a finite element analysis was performed in order to validate the model. A second validation was performed by comparing simulated patellofemoral kinematics to in-vivo values obtained from upright- weight bearing CT scans. Subsequently, five trochleodysplastic knees were modelled before and after simulated trochleoplasty. The force necessary to dislocate the patella by 10 mm and to fully dislocate the patella was calculated in various knee flexion angles between 0 and 45°.
Findings
The developed models successfully predicted outcome values within the range of reference values from literature. Lateral stability was significantly lower in trochleodysplastic knees compared to healthy knees. Trochleoplasty was determined to significantly increase the force necessary to dislocate the patella in trochleodysplastic knees to comparable values as in healthy knees.
Interpretation
This is the first study to investigate lateral patellofemoral stability in patients with symptomatic patellofemoral instability and dysplasia of the trochlear groove. We confirm that patellofemoral stability is significantly lower in trochleodysplastic knees than in healthy knees. Trochleoplasty increases patellofemoral stability to levels similar to healthy.
Permanent link
Publication status
published
Editor
Book title
Journal / series
Volume
81
Pages / Article No.
105216
Publisher
Elsevier
Event
Edition / version
Methods
Software
Geographic location
Date collected
Date created
Subject
FE; Finite element; LPFL; lateral patellofemoral ligament; MPFL; medial patellofemoral ligament; MPML; medial patellomeniscal ligament
Organisational unit
03822 - Snedeker, Jess G. / Snedeker, Jess G.