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J Knee Surg 2017; 30(09): 863-871
DOI: 10.1055/s-0036-1597976
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Implant Design and Effects on Patellofemoral Crepitus

David Clinton McNabb
1   Department of Orthopedic Surgery, Raleigh Orthopaedic Clinic, Raleigh, North Carolina
,
Douglas A. Dennis
2   Department of Colorado Joint Replacement, Porter Adventist Hospital Ringgold Standard Institution, Denver, Colorado
3   Department of Biomedical Engineering, University of Denver Ringgold Standard Institution, Denver, Colorado
4   Department of Biomedical Engineering, University of Tennessee Ringgold Standard Institution, Knoxville, Tennessee
5   Department of Orthopedics, University of Colorado Denver School of Medicine Ringgold Standard Institution, Aurora, Colorado
,
Jason M. Jennings
2   Department of Colorado Joint Replacement, Porter Adventist Hospital Ringgold Standard Institution, Denver, Colorado
,
Brian Daines
6   Department of Orthopedics, Sierra Vista Medical Group, Sierra Vista, Arizona
,
Peter Laz
3   Department of Biomedical Engineering, University of Denver Ringgold Standard Institution, Denver, Colorado
,
Raymond H. Kim
2   Department of Colorado Joint Replacement, Porter Adventist Hospital Ringgold Standard Institution, Denver, Colorado
7   Department of Mechanical and Materials Engineering, University of Denver, Denver, Colorado
8   Department of Orthopedic Surgery, Joan C Edwards School of Medicine at Marshall University Ringgold Standard Institution, Huntington, West Virginia
› Author Affiliations
Further Information

Publication History

19 July 2016

06 December 2016

Publication Date:
23 January 2017 (online)

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Abstract

Background Patellofemoral crepitus is a known complication of posterior stabilized (PS) total knee arthroplasty (TKA). This study compared the incidence of patellofemoral crepitus between two femoral components designs.

Materials and Methods Between January 2005 and August 2010, 1,120 patients with complete 2-year follow-up had a PS TKA with two different prosthetic designs (group A, 553 patients; group B, 567 patients). Records were reviewed to identify the incidence of total, symptomatic, and operative patellofemoral crepitus.

Results No statistical differences were observed in the incidence of total patellofemoral crepitus (group A 14.1%, group B 14.5%; p = 0.932) or symptomatic patellofemoral crepitus (group A 5.6%, group B 4.2%; p = 0.334). The incidence of operative crepitus was greater in group A (3.3%) than in group B (1.3%; p = 0.026). Analysis of mobile versus fixed bearing designs showed a higher incidence of total patellofemoral crepitus in mobile bearing TKA (16.04 vs. 4.93%; p = 0.006) within group B only.

Conclusion Femoral component design with a smoother intercondylar box transition zone resulted in a lower incidence of operative patellofemoral crepitus. No statistical differences were noted regarding the incidence of total and symptomatic patellofemoral crepitus. Mobile bearing TKA exhibited greater total crepitus within group B.

Level of Evidence Level III.

Keywords

total knee arthroplasty - patellofemoral crepitus - implant design
 

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