Skip to Main Content
 

Global Search Box

 
 
 
 

Files

File List


MINGELS_2016_FINAL.pdf (2.6 MB)

ETD Abstract Container

Abstract Header

Mechanics of Patellofemoral Maltracking in Total Knee Arthroplasty: A Finite Element Analysis

Ingels, Marcel L
http://rave.ohiolink.edu/etdc/view?acc_num=toledo1481051417682463

Abstract Details

2016, Master of Science, University of Toledo, Bioengineering.
The patellofemoral joint is a complex joint that accounts for a large percentage of knee problems both in knee arthroplasty and in intact knee mechanics. In the United States alone, a 673% increase in primary total knee arthroplasty surgeries performed per year is projected to occur by 2030 (i.e., 3.48 million procedures). Consequently, the total revision rate per year is also projected to increase by 601% by 2030 (i.e., 268,200 revisions). Complication of the patellofemoral joint, associated with the patella maltracking, is one of the most common reasons for revisions in total knee arthroplasty and anterior pain of the intact knee. Thus, understanding patellofemoral maltracking mechanics and its associated risk factors is necessary. This study developed a validated finite element model of an intact knee to compare with instrumented knee patellar mechanics. The biomechanics of a maltracking patella are complex and have been shown to be associated with patellar subluxation, increased Q-angle, and increased external tibial rotation. These risk factors were applied individually and in combination to both an intact knee model and a knee instrumented with a total knee arthroplasty system to observe their effect on patellar mechanics. Thecombination of risk factors resulted in a worst-case maltracking model that was instrumented with a translating patellar implant with the goal of improving patellofemoral mechanics under maltracking conditions. The results of this study showed that the worst occurrence of patellar maltracking occurs because of a combination of various risk factors, such as patellar subluxation, increased Q-angle, and increased external tibial rotation for both intact and instrumented knees. Of these risk factors, the former contributes substantially more toward inducing non-physiological patellar mechanics than the latter two. Among the kinematic indicators for patellar maltracking in intact knees, medial/lateral patellar translation and tilt were ideal, whereas patellar rotation, although provided valuable insight on the patellofemoral joint kinematics, failed in showing any trend toward patellar maltracking. Among the kinematic indicators for patellar maltracking in instrumented knees, medial/lateral patellar translation was ideal, whereas patellar tilt and rotation, although provided valuable insight on the patellofemoral joint kinematics, failed in showing any trend toward patellar maltracking. Nevertheless, implant designers and clinicians should consider the rotation and tilt of the patella under various physiological conditions as design inputs for devices and conservative treatments. Lastly, the results of this study were used in designing a translating patellar implant that showed to reduce the risk of patellar maltracking, corroborating the value of aforementioned trends and kinematic indicators.
Vijay Goel, PhD (Committee Chair)
Anand Agarwal, PhD (Committee Member)
Ronald Fournier, PhD (Committee Member)
Biomedical Engineering

Recommended Citations

Citations

  • Ingels, M. L. (2016). Mechanics of Patellofemoral Maltracking in Total Knee Arthroplasty: A Finite Element Analysis [Master's thesis, University of Toledo]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1481051417682463

    APA Style (7th edition)

  • Ingels, Marcel. Mechanics of Patellofemoral Maltracking in Total Knee Arthroplasty: A Finite Element Analysis. 2016. University of Toledo, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=toledo1481051417682463.

    MLA Style (8th edition)

  • Ingels, Marcel. "Mechanics of Patellofemoral Maltracking in Total Knee Arthroplasty: A Finite Element Analysis." Master's thesis, University of Toledo, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1481051417682463

    Chicago Manual of Style (17th edition)

toledo1481051417682463
495
© 2016, all rights reserved.
This open access ETD is published by University of Toledo and OhioLINK.