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Influence of the patellar button thickness on the knee flexion after total knee arthroplasty

Rosso I., Surface C., Antonaci P., Surface F. M., Negretto R. J.

Acta of Bioengineering and Biomechanics

2018

Vol. 20, no. 4

121-134

One of the main problems of knee replacement is the limit of knee flexion. This study focuses on the knee implant and the patellar component currently in use in total knee arthroplasty, analyzing the influence of patellar thickness on the degree of knee flexion following surgery. Methods: A kinematics study was performed to evaluate whether an optimal patellar thickness can be identified, which enables the maximum flexion angle to be achieved. Using TC images, a healthy model was built. On this basis, a model of a knee joint which had undergone total knee arthroplasty using a Legion PS prosthesis was constructed. Initially, the standard thickness of patellar implant (9 mm) was used to build the model; then several different patellar implant thicknesses (in the range of 5–15 mm) were analyzed. Results: The results show a non-linear trend: a button thickness of less than 9 mm does not change the flexion angle, whereas a button thickness of over 9 mm results in a loss of flexion. The flexion loss is significant in the first two additions of thicknesses but negligible in the last ones. Conclusions: In the case studied, flexion reduction is not linearly proportional to the patellar thickness. The outcome of total knee arthroplasty is considered to be satisfactory with the standard patellar button. The results of this study could be used to compare the kinematics with other total prosthesis and patellar implants, and should enable the optimization of the patellar residue bone thickness to obtain deep flexion.

Flexion and Extension Angles of Resting Fingers and Wrist

Lee K.-S., Jung M.- C.

International Journal of Occupational Safety and Ergonomics

2014

Vol. 20, No. 1

91--101

This study determined flexion and extension angles of resting fingers and wrist in terms of forearm posture (neutral, pronation and supination) and shoulder flexion (0°, 45°, 90° and 135°). The participants participated in 12 angle measurements for 16 finger joints and wrist. The finger joints flexed more in supination than in neutral posture and pronation and the thumb flexed more than the other fingers because of the gravity and skin tension. This phenomenon became more apparent as the shoulder flexed. The carpometacarpal joint had the largest flexion angle in the thumb joints, whereas the proximal interphalangeal joints had the largest flexion angles in the other finger joints. The resting posture of the wrist extended of ~16° in any forearm postures when the shoulder was at 0°. The results of this study could be useful for rehabilitation tool and product designs.