Distal femoral condyle is more internally rotated to the patellar tendon at 90° of flexion in normal knees

Shinya Kawahara, Ken Okazaki, Shuichi Matsuda, Hiroyuki Nakahara, Shigetoshi Okamoto, Yukihide Iwamoto

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The configuration of the distal surface of the femur would be more important in terms of the patellofemoral (PF) joint contact because the patella generally contacts with the distal surface of the femur in knee flexion. Some total knee arthroplasty (TKA) designs configurate medially prominent asymmetric femoral condyles. This difference in the design of distal femoral condyle may affect the PF joint congruity in knee flexion. Furthermore, some surgeons advocate a concept aligning the symmetric components parallel to the native joint inclination, not perpendicular to the mechanical axis. This concept would also make a difference on the PF joint congruity at the distal femur in knee flexion. However, no fundamental study has been reported on the PF congruity at the distal femur to discuss the theoretical priority of these concepts. Methods: The open magnetic resonance images of 45 normal knees at 90° of flexion were used to measure the angles between the tibial attachment of the patellar tendon, the equatorial line of the patella, and the distal surface of femoral condyles. Results: The distal surface of femoral condyles was internally rotated relative to the tibial attachment of the patellar tendon and the equatorial line of the patella in all the knees (8.2° ± 3.5° and 5.8° ± 2.5°, respectively), not parallel. Conclusions: Distal femoral condyle is internally rotated to the patellar tendon at 90° of flexion in normal knees. When the symmetric femoral component is aligned perpendicular to the femoral mechanical axis, the patellar tendon would be possibly more twisted than the condition in normal knees, and the deviation of the PF contact force on the patellar component might be caused. The configuration and alignment of the distal condyle of the femoral component can affect the PF joint congruity in knee flexion. In this respect, our results provide important information in considering designs and alignment in the distal femur of TKA and the PF joint congruity in knee flexion.

Original languageEnglish
Article number54
JournalJournal of Orthopaedic Surgery and Research
Volume10
Issue number1
DOIs
Publication statusPublished - Apr 25 2015

Fingerprint

Patellar Ligament
Thigh
Knee
Patellofemoral Joint
Bone and Bones
Femur
Patella
Knee Replacement Arthroplasties
Magnetic Resonance Spectroscopy
Joints

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Distal femoral condyle is more internally rotated to the patellar tendon at 90° of flexion in normal knees. / Kawahara, Shinya; Okazaki, Ken; Matsuda, Shuichi; Nakahara, Hiroyuki; Okamoto, Shigetoshi; Iwamoto, Yukihide.

In: Journal of Orthopaedic Surgery and Research, Vol. 10, No. 1, 54, 25.04.2015.

Research output: Contribution to journalArticle

Kawahara, Shinya ; Okazaki, Ken ; Matsuda, Shuichi ; Nakahara, Hiroyuki ; Okamoto, Shigetoshi ; Iwamoto, Yukihide. / Distal femoral condyle is more internally rotated to the patellar tendon at 90° of flexion in normal knees. In: Journal of Orthopaedic Surgery and Research. 2015 ; Vol. 10, No. 1.
@article{c6f5006ccf7f4634a43d026fd7a432e8,
title = "Distal femoral condyle is more internally rotated to the patellar tendon at 90° of flexion in normal knees",
abstract = "Background: The configuration of the distal surface of the femur would be more important in terms of the patellofemoral (PF) joint contact because the patella generally contacts with the distal surface of the femur in knee flexion. Some total knee arthroplasty (TKA) designs configurate medially prominent asymmetric femoral condyles. This difference in the design of distal femoral condyle may affect the PF joint congruity in knee flexion. Furthermore, some surgeons advocate a concept aligning the symmetric components parallel to the native joint inclination, not perpendicular to the mechanical axis. This concept would also make a difference on the PF joint congruity at the distal femur in knee flexion. However, no fundamental study has been reported on the PF congruity at the distal femur to discuss the theoretical priority of these concepts. Methods: The open magnetic resonance images of 45 normal knees at 90° of flexion were used to measure the angles between the tibial attachment of the patellar tendon, the equatorial line of the patella, and the distal surface of femoral condyles. Results: The distal surface of femoral condyles was internally rotated relative to the tibial attachment of the patellar tendon and the equatorial line of the patella in all the knees (8.2° ± 3.5° and 5.8° ± 2.5°, respectively), not parallel. Conclusions: Distal femoral condyle is internally rotated to the patellar tendon at 90° of flexion in normal knees. When the symmetric femoral component is aligned perpendicular to the femoral mechanical axis, the patellar tendon would be possibly more twisted than the condition in normal knees, and the deviation of the PF contact force on the patellar component might be caused. The configuration and alignment of the distal condyle of the femoral component can affect the PF joint congruity in knee flexion. In this respect, our results provide important information in considering designs and alignment in the distal femur of TKA and the PF joint congruity in knee flexion.",
author = "Shinya Kawahara and Ken Okazaki and Shuichi Matsuda and Hiroyuki Nakahara and Shigetoshi Okamoto and Yukihide Iwamoto",
year = "2015",
month = "4",
day = "25",
doi = "10.1186/s13018-015-0197-5",
language = "English",
volume = "10",
journal = "Journal of Orthopaedic Surgery and Research",
issn = "1749-799X",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Distal femoral condyle is more internally rotated to the patellar tendon at 90° of flexion in normal knees

AU - Kawahara, Shinya

AU - Okazaki, Ken

AU - Matsuda, Shuichi

AU - Nakahara, Hiroyuki

AU - Okamoto, Shigetoshi

AU - Iwamoto, Yukihide

PY - 2015/4/25

Y1 - 2015/4/25

N2 - Background: The configuration of the distal surface of the femur would be more important in terms of the patellofemoral (PF) joint contact because the patella generally contacts with the distal surface of the femur in knee flexion. Some total knee arthroplasty (TKA) designs configurate medially prominent asymmetric femoral condyles. This difference in the design of distal femoral condyle may affect the PF joint congruity in knee flexion. Furthermore, some surgeons advocate a concept aligning the symmetric components parallel to the native joint inclination, not perpendicular to the mechanical axis. This concept would also make a difference on the PF joint congruity at the distal femur in knee flexion. However, no fundamental study has been reported on the PF congruity at the distal femur to discuss the theoretical priority of these concepts. Methods: The open magnetic resonance images of 45 normal knees at 90° of flexion were used to measure the angles between the tibial attachment of the patellar tendon, the equatorial line of the patella, and the distal surface of femoral condyles. Results: The distal surface of femoral condyles was internally rotated relative to the tibial attachment of the patellar tendon and the equatorial line of the patella in all the knees (8.2° ± 3.5° and 5.8° ± 2.5°, respectively), not parallel. Conclusions: Distal femoral condyle is internally rotated to the patellar tendon at 90° of flexion in normal knees. When the symmetric femoral component is aligned perpendicular to the femoral mechanical axis, the patellar tendon would be possibly more twisted than the condition in normal knees, and the deviation of the PF contact force on the patellar component might be caused. The configuration and alignment of the distal condyle of the femoral component can affect the PF joint congruity in knee flexion. In this respect, our results provide important information in considering designs and alignment in the distal femur of TKA and the PF joint congruity in knee flexion.

AB - Background: The configuration of the distal surface of the femur would be more important in terms of the patellofemoral (PF) joint contact because the patella generally contacts with the distal surface of the femur in knee flexion. Some total knee arthroplasty (TKA) designs configurate medially prominent asymmetric femoral condyles. This difference in the design of distal femoral condyle may affect the PF joint congruity in knee flexion. Furthermore, some surgeons advocate a concept aligning the symmetric components parallel to the native joint inclination, not perpendicular to the mechanical axis. This concept would also make a difference on the PF joint congruity at the distal femur in knee flexion. However, no fundamental study has been reported on the PF congruity at the distal femur to discuss the theoretical priority of these concepts. Methods: The open magnetic resonance images of 45 normal knees at 90° of flexion were used to measure the angles between the tibial attachment of the patellar tendon, the equatorial line of the patella, and the distal surface of femoral condyles. Results: The distal surface of femoral condyles was internally rotated relative to the tibial attachment of the patellar tendon and the equatorial line of the patella in all the knees (8.2° ± 3.5° and 5.8° ± 2.5°, respectively), not parallel. Conclusions: Distal femoral condyle is internally rotated to the patellar tendon at 90° of flexion in normal knees. When the symmetric femoral component is aligned perpendicular to the femoral mechanical axis, the patellar tendon would be possibly more twisted than the condition in normal knees, and the deviation of the PF contact force on the patellar component might be caused. The configuration and alignment of the distal condyle of the femoral component can affect the PF joint congruity in knee flexion. In this respect, our results provide important information in considering designs and alignment in the distal femur of TKA and the PF joint congruity in knee flexion.

UR - http://www.scopus.com/inward/record.url?scp=84928313678&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928313678&partnerID=8YFLogxK

U2 - 10.1186/s13018-015-0197-5

DO - 10.1186/s13018-015-0197-5

M3 - Article

C2 - 25906977

AN - SCOPUS:84928313678

VL - 10

JO - Journal of Orthopaedic Surgery and Research

JF - Journal of Orthopaedic Surgery and Research

SN - 1749-799X

IS - 1

M1 - 54

ER -