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The patella, with or without resurfacing, plays a fundamental role in the success of a total knee arthroplasty (TKA). Patellofemoral joint complications are due to problems related to the patient, to the surgical technique, or to the design of the components. Patellar tracking is influenced by several factors: a severe preoperative valgus, the presence of pre-existing patellofemoral dysplasia, ...

We measured the pressure distribution across the tibiofemoral and patellofemoral joints during total knee arthroplasty (TKA) using Fuji pressure-sensitive film (Prescale) in 51 patients (63 joints) comparing the results with those in 21 patients in whom Prescale was not used. We classified the stress-distribution patterns in the tibiofemoral joints into four types: normal, varus-valgus instabil...

Malrotation of the femoral component is a cause of patellofemoral maltracking after total knee arthroplasty. Its precise effect on the patellofemoral mechanics has not been well quantified. We have developed an in vitro method to measure the influence of patellar maltracking on contact. Maltracking was induced by progressively rotating the femoral component either internally or externally. The ...

The results of a multi-surgeon, multi-implant series of patellofemoral joint arthroplasties performed over a ten year period are presented. All patellofemoral joint arthroplasties performed from 1997 to 2006 were retrospectively reviewed using case notes, radiographs and clinic appointments until their latest follow-up period. One hundred and one arthroplasties in 91 patients were followed up f...

Patellar resurfacing in total knee arthroplasty remains controversial. This study compared the long-term clinical outcomes of total knee arthroplasties performed with and without the patella resurfaced and is an update of a previous report. Eighty-six patients (118 knees) underwent primary total knee replacement and were randomized into two groups: those treated with and those treated without r...

Using a new, non-invasive method, we measured the patellofemoral force (PFF) in cadaver knees mounted in a rig to simulate weight-bearing. The PFF was measured from 20 degrees to 120 degrees of flexion before and after implanting three designs of knee prosthesis. Medial unicompartmental arthroplasty with a meniscal-bearing prosthesis and with retention of both cruciate ligaments caused no signi...