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J Knee Surg 2021; 34(04): 444-451
DOI: 10.1055/s-0039-1696958
Original Article

Influence of Variation in Sagittal Placement of the Femoral Component after Cruciate-Retaining Total Knee Arthroplasty

Yong-Gon Koh‡   ∗
1   Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, Seocho-gu, Seoul, Republic of Korea
,
Hyoung-Taek Hong‡   ∗
2   Department of Mechanical Engineering, Yonsei University, Seodaemun-gu, Seoul, Republic of Korea
,
Hwa-Yong Lee
2   Department of Mechanical Engineering, Yonsei University, Seodaemun-gu, Seoul, Republic of Korea
,
Hyo-Jeong Kim
3   Department of Sport and Healthy Aging, Korea National Sport University, Seoul, Republic of Korea
,
Kyoung-Tak Kang 
2   Department of Mechanical Engineering, Yonsei University, Seodaemun-gu, Seoul, Republic of Korea
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Abstract

Prosthetic alignment is an important factor for long-term survival in cruciate-retaining (CR) total knee arthroplasty (TKA). The purpose of this study is to investigate the influence of sagittal placement of the femoral component on tibiofemoral (TF) kinematics and kinetics in CR-TKA. Five sagittal placements of femoral component models with −3, 0, 3, 5, and 7 degrees of flexion are developed. The TF joint kinematics, quadriceps force, patellofemoral contact force, and posterior cruciate ligament force are evaluated using the models under deep knee-bend loading. The kinematics of posterior TF translation is found to occur with the increase in femoral-component flexion. The quadriceps force and patellofemoral contact force decrease with the femoral-component flexion increase. In addition, extension of the femoral component increases with the increase in posterior cruciate ligament force. The flexed femoral component in CR-TKA provides a positive biomechanical effect compared with a neutral position. Slight flexion could be an effective alternative technique to enable positive biomechanical effects with TKA prostheses.

Keywords

femoral-component sagittal placement - total knee arthroplasty - cruciate retention - tibiofemoral

∗ Yong-Gon Koh and Hyoung-Taek Hong contributed equally to this work and should be considered co-first authors.




Publication History

Received: 12 September 2018

Accepted: 26 July 2019

Article published online:
09 September 2019

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