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research article

A patient-specific model of total knee arthroplasty to estimate patellar strain: A case study

Latypova, Adeliya  
•
Arami, Arash
•
Becce, Fabio
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2016
Clinical Biomechanics

Inappropriate patellar cut during total knee arthroplasty can lead to patellar complications due to increased bone strain. In this study, we evaluated patellar bone strain of a patient who had a deeper patellar cut than the recommended. A patient-specific model based on patient preoperative data was created. The model was decoupled into two levels: knee and patella. The knee model predicted kinematics and forces on the patella during squat movement. The patella model used these values to predict bone strain after total knee arthroplasty. Mechanical properties of the patellar bone were identified with micro-finite element modeling testing of cadaveric samples. The model was validated with a robotic knee simulator and postoperative X-rays. For this patient, we compared the deeper patellar cut depth to the recommended one, and evaluated patellar bone volume with octahedral shear strain above 1%. Model predictions were consistent with experimental measurements of the robotic knee simulator and postoperative X-rays. Compared to the recommended cut, the deeper cut increased the critical strain bone volume, but by less than 3% of total patellar volume. We thus conclude that the predicted increase in patellar strain should be within an acceptable range, since this patient had no complaints 8 months after surgery. This validated patient-specific model will later be used to address other questions on groups of patients, to eventually improve surgical planning and outcome of total knee arthroplasty.

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Type
research article
DOI
10.1016/j.clinbiomech.2015.11.008
Web of Science ID

WOS:000372689400032

Author(s)
Latypova, Adeliya  
Arami, Arash
Becce, Fabio
Jolles-Haeberli, Brigitte
Aminian, Kamiar
Pioletti, Dominique P.  
Terrier, Alexandre  
Date Issued

2016

Publisher

Elsevier

Published in
Clinical Biomechanics
Volume

32

Start page

212

End page

219

Subjects

Knee

•

Arthroplasty

•

Patella

•

Strain

•

Kinematics

•

Finite elements

Editorial or Peer reviewed

NON-REVIEWED

Written at

EPFL

EPFL units
LBO  
Available on Infoscience
December 7, 2015
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/121474
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