A new design of total knee prosthesis without anterior patellar flange was developed to preserve the anatomical shape of the patellofemoral joint. The aim of the current study was to experimentally compare patellofemoral contact area and pressure in a nonreplaced knee, in a knee after implantation of a conventionally designed total knee arthroplasty, and in a knee after implantation of the newly designed total knee arthroplasty without patellar flange. Six cadaveric legs were examined before and after implantation of either a conventional or a newly developed total knee arthroplasty, both without patellar replacement. The essential change in design is the absence of an anterior patellar flange. Contact area and pressure were measured using pressure sensitive films in 45°, 60°, 90°, and 120° of flexion and the results were compared between the different prosthesis designs and with the nonreplaced knee. The prosthesis without patellar flange showed less average and maximum pressure than the conventional prosthesis. Compared with the nonreplaced knee, the conventional prosthesis led to increased average and maximum pressure and decreased contact area. In an experimental test setup, the newly developed total knee arthroplasty without patellar flange showed reduced patello-femoral contact pressure in comparison with a total knee prosthesis with conventional patellofemoral design. This could possibly lead to a lower incidence of anterior knee complaints in patients.
Dept. of Orthopaedics, University Hospital Muenster, Albert-Schweitzer-Strasse 33, 48129 Muenster, Germany