Affiliations: [a] Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea | [b] Department of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea | [c] Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
Correspondence:
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Corresponding authors: Joon-Hee Park, Ph.D., Department of Anesthesiology & Pain Medicine, Hallym University College of Medicine and Kangdong Sacred Heart Hospital, 150 Seongan-ro, Gangdong-gu, Seoul 05355, Republic of Korea. Tel.: +82 2 2123 4827; Fax: +82 2 362 2736; E-mail: [email protected]. Kyoung-Tak Kang, Ph.D., Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. Tel.: +82 2 2123 4827; Fax: +82 2 362 2736; E-mail: [email protected]
Note: [†] Yong-Gon Koh and Jin-Ah Lee contributed equally to this work and should be considered co-first authors.
Abstract: BACKGROUND:Recently, there has been an increasing interest in mobile-bearing total knee arthroplasty (TKA). However, changes in biomechanics for femoral component alignment in mobile-bearing TKA have not been explored in depth. OBJECTIVE:This study aims to evaluate the biomechanical effect of sagittal alignment of the femoral component in mobile-bearing TKA. METHODS:We developed femoral sagittal alignment models with −3°, 0°, 3°, 5°, and 7° flexion. We also examine the kinematics of the tibiofemoral (TF) joint, contact point on the TF joint, contact stress on the patellofemoral (PF) joint, collateral ligament force, and quadriceps force using a validated computational model under a deep-knee-bend condition. RESULTS:Posterior kinematics of the TF joint increases as the femoral component flexes. The contact stress on the PF joint, collateral ligament force, and the quadriceps force decreases as the femoral component flexes. CONCLUSIONS:Our results show that a slight, approximately 0°∼3°, flexion of the implantation could be an effective substitute technique. However, excessive flexion should be avoided because of the potential loosening of the TF joint.
Keywords: Total knee arthroplasty, mobile-bearing, misalignment, finite element analysis
