Higher patellofemoral compressive force does not affect anterior knee pain in anatomical bi-cruciate retaining total knee arthroplasty: In vivo prospective analysis of guided motion prosthesis. (August 2021) - Toyoda, Shinya
Abstract: Background: The purposes of the present study are 1) to measure intraoperative patellofemoral compressive force in patients undergoing anatomical bi-cruciate retaining total knee arthroplasty and to assess the relationship between intraoperative patellofemoral compressive force and patient reported outcome measurements and 2) to compare patellofemoral compressive force and patient reported outcome measurements among patients who underwent anatomical bi-cruciate retaining, cruciate retaining, and bi-cruciate stabilized total knee arthroplasty. Methods: Twenty-two patients with varus osteoarthritis of the knee who underwent anatomical bi-cruciate retaining total knee arthroplasty, 20 patients who underwent cruciate retaining total knee arthroplasty, and 24 patients who underwent bi-cruciate stabilized total knee arthroplasty were assessed. Patient reported outcome measurements were evaluated at 1.5 years after surgery. Findings: Intraoperative patellofemoral compressive force was significantly lower with anatomical bi-cruciate retaining total knee arthroplasty than with cruciate retaining total knee arthroplasty at 60° to 140° of flexion and nearly equivalent to intraoperative patellofemoral compressive force with bi-cruciate stabilized total knee arthroplasty at all knee flexion angles examined. With anatomical bi-cruciate retaining total knee arthroplasty, there were no significant correlations between intraoperative patellofemoral compressive force and almost all patient reported outcome measurements except for 2011 Knee Society Score expectations, which was positively correlated with patellofemoral compressive force at 10° of flexion, and Patella score quadriceps strength, which was negatively correlated with patellofemoral compressive force at 60° of flexion. Interpretation: There were no significant correlations between intraoperative patellofemoral compressive force and anterior knee pain after anatomical bi-cruciate retaining total knee arthroplasty. Evidence level : 3. Highlights: Patellar contact force was significantly lower in bi-cruciate retaining than in cruciate retaining. There was no correlation between patellar contact force and anterior knee pain. Lower patellar contact force at 60 degrees of knee flexion improved the patella score.