Title: Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study
Authors: van Jonbergen, Hans-Peter W ×
Innocenti, Bernardo
Gervasi, Gian Luca
Labey, Luc
Verdonschot, Nico #
Issue Date: 2012
Publisher: BioMed Central
Series Title: Journal of Orthopaedic Surgery and Research vol:7
Article number: ARTN 28
Abstract: Background: Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral
osteoarthritis. However, results of later conversion to total knee replacement may be compromised by periprosthetic bone loss. Previous clinical studies have demonstrated a decrease in distal femoral bone mineral density after patellofemoral joint replacement. It is unclear whether this is due to periprosthetic stress shielding. The main objective of the current study was to evaluate the stress shielding effect of prosthetic replacement with 2 different patellofemoral prosthetic designs and with a total knee prosthesis.
Methods: We developed a finite element model of an intact patellofemoral joint, and finite element models of patellofemoral joint replacement with a Journey PFJ prosthesis, a Richards II prosthesis, and a Genesis II total knee prosthesis. For each of these 4 finite element models, the average Von Mises stress in 2 clinically relevant regions of interest were evaluated during a simulated squatting movement until 120 degrees of flexion.
Results: During deep knee flexion, in the anterior region of interest, the average Von Mises stress with the Journey
PFJ design was comparable to the physiological knee, while reduced by almost 25% for both the Richards II design and the Genesis II total knee joint replacement design. The average Von Mises stress in the supracondylar region of
interest was similar for both patellofemoral prosthetic designs and the physiological model, with slightly lower
stress for the Genesis II design.
Conclusions: Patellofemoral joint replacement results in periprosthetic stress-shielding, although to a smaller degree than in total knee replacement. Specific patellofemoral prosthetic design properties may result in differences in femoral stress shielding.
ISSN: 1749-799X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Non-KU Leuven Association publications
× corresponding author
# (joint) last author

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