Biomechanical effects of total knee arthroplasty component malrotation: A computational simulation

Julie A. Thompson, Michael W. Hast, Jeffrey F. Granger, Stephen J. Piazza, Robert A. Siston

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Modern total knee arthroplasty (TKA) is an effective procedure to treat pain and disability due to osteoarthritis, but some patients experience quadriceps weakness after surgery and have difficulty performing important activities of daily living. The success of TKA depends on many factors, but malalignment of the prosthetic components is a major cause of postoperative complications. Significant variability is associated with femoral and tibial component rotational alignment, but how this variability translates into functional outcome remains unknown. We used a forward-dynamic computer model of a simulated squatting motion to perform a parametric study of the effects of variations in component rotational alignment in TKA. A cruciate-retaining and posterior-stabilized version of the same TKA implant were compared. We found that femoral rotation had a greater effect on quadriceps forces, collateral ligament forces, and varus/valgus kinematics, while tibial rotation had a greater effect on anteroposterior translations. Our findings support the tendency for orthopedic surgeons to bias the femoral component into external rotation and avoid malrotation of the tibial component.

Original languageEnglish (US)
Pages (from-to)969-975
Number of pages7
JournalJournal of Orthopaedic Research
Volume29
Issue number7
DOIs
StatePublished - Jul 1 2011

Fingerprint

Knee Replacement Arthroplasties
Thigh
Collateral Ligaments
Activities of Daily Living
Biomechanical Phenomena
Osteoarthritis
Computer Simulation
Pain

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Cite this

Thompson, Julie A. ; Hast, Michael W. ; Granger, Jeffrey F. ; Piazza, Stephen J. ; Siston, Robert A. / Biomechanical effects of total knee arthroplasty component malrotation : A computational simulation. In: Journal of Orthopaedic Research. 2011 ; Vol. 29, No. 7. pp. 969-975.
@article{5106d782850540f9b2d1fa5b390da81c,
title = "Biomechanical effects of total knee arthroplasty component malrotation: A computational simulation",
abstract = "Modern total knee arthroplasty (TKA) is an effective procedure to treat pain and disability due to osteoarthritis, but some patients experience quadriceps weakness after surgery and have difficulty performing important activities of daily living. The success of TKA depends on many factors, but malalignment of the prosthetic components is a major cause of postoperative complications. Significant variability is associated with femoral and tibial component rotational alignment, but how this variability translates into functional outcome remains unknown. We used a forward-dynamic computer model of a simulated squatting motion to perform a parametric study of the effects of variations in component rotational alignment in TKA. A cruciate-retaining and posterior-stabilized version of the same TKA implant were compared. We found that femoral rotation had a greater effect on quadriceps forces, collateral ligament forces, and varus/valgus kinematics, while tibial rotation had a greater effect on anteroposterior translations. Our findings support the tendency for orthopedic surgeons to bias the femoral component into external rotation and avoid malrotation of the tibial component.",
author = "Thompson, {Julie A.} and Hast, {Michael W.} and Granger, {Jeffrey F.} and Piazza, {Stephen J.} and Siston, {Robert A.}",
year = "2011",
month = "7",
day = "1",
doi = "10.1002/jor.21344",
language = "English (US)",
volume = "29",
pages = "969--975",
journal = "Journal of Orthopaedic Research",
issn = "0736-0266",
publisher = "John Wiley and Sons Inc.",
number = "7",

}

Biomechanical effects of total knee arthroplasty component malrotation : A computational simulation. / Thompson, Julie A.; Hast, Michael W.; Granger, Jeffrey F.; Piazza, Stephen J.; Siston, Robert A.

In: Journal of Orthopaedic Research, Vol. 29, No. 7, 01.07.2011, p. 969-975.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Biomechanical effects of total knee arthroplasty component malrotation

T2 - A computational simulation

AU - Thompson, Julie A.

AU - Hast, Michael W.

AU - Granger, Jeffrey F.

AU - Piazza, Stephen J.

AU - Siston, Robert A.

PY - 2011/7/1

Y1 - 2011/7/1

N2 - Modern total knee arthroplasty (TKA) is an effective procedure to treat pain and disability due to osteoarthritis, but some patients experience quadriceps weakness after surgery and have difficulty performing important activities of daily living. The success of TKA depends on many factors, but malalignment of the prosthetic components is a major cause of postoperative complications. Significant variability is associated with femoral and tibial component rotational alignment, but how this variability translates into functional outcome remains unknown. We used a forward-dynamic computer model of a simulated squatting motion to perform a parametric study of the effects of variations in component rotational alignment in TKA. A cruciate-retaining and posterior-stabilized version of the same TKA implant were compared. We found that femoral rotation had a greater effect on quadriceps forces, collateral ligament forces, and varus/valgus kinematics, while tibial rotation had a greater effect on anteroposterior translations. Our findings support the tendency for orthopedic surgeons to bias the femoral component into external rotation and avoid malrotation of the tibial component.

AB - Modern total knee arthroplasty (TKA) is an effective procedure to treat pain and disability due to osteoarthritis, but some patients experience quadriceps weakness after surgery and have difficulty performing important activities of daily living. The success of TKA depends on many factors, but malalignment of the prosthetic components is a major cause of postoperative complications. Significant variability is associated with femoral and tibial component rotational alignment, but how this variability translates into functional outcome remains unknown. We used a forward-dynamic computer model of a simulated squatting motion to perform a parametric study of the effects of variations in component rotational alignment in TKA. A cruciate-retaining and posterior-stabilized version of the same TKA implant were compared. We found that femoral rotation had a greater effect on quadriceps forces, collateral ligament forces, and varus/valgus kinematics, while tibial rotation had a greater effect on anteroposterior translations. Our findings support the tendency for orthopedic surgeons to bias the femoral component into external rotation and avoid malrotation of the tibial component.

UR - http://www.scopus.com/inward/record.url?scp=79955895576&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955895576&partnerID=8YFLogxK

U2 - 10.1002/jor.21344

DO - 10.1002/jor.21344

M3 - Article

C2 - 21567450

AN - SCOPUS:79955895576

VL - 29

SP - 969

EP - 975

JO - Journal of Orthopaedic Research

JF - Journal of Orthopaedic Research

SN - 0736-0266

IS - 7

ER -