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Biomechanical effects of total knee arthroplasty component malrotation: A computational simulation
Author(s) -
Thompson Julie A.,
Hast Michael W.,
Granger Jeffrey F.,
Piazza Stephen J.,
Siston Robert A.
Publication year - 2011
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.21344
Subject(s) - squatting position , medicine , orthopedic surgery , valgus , orthodontics , posterior cruciate ligament , kinematics , total knee arthroplasty , arthroplasty , implant , osteoarthritis , tibia , physical medicine and rehabilitation , physical therapy , surgery , anterior cruciate ligament , physics , alternative medicine , classical mechanics , pathology
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. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 29: 969–975, 2011