Purpose: The purpose of this study was to investigate the relationship between patellofemoral (PF) contact stress in vivo and the alignment of the femoral component in patients after total knee arthroplasty (TKA).
Methods: Thirty knees with medial compartment osteoarthritis that underwent mobile-bearing TKA with modified gap technique were evaluated. Surgery was performed using a subvastus approach to eliminate the effect of the approach to muscle balance, with a computed tomography-based navigation system (Vector Vision 1.61; Brain Lab, Heimstetten, Germany). PF contact stress was measured by a Flexiforce pressure sensor (Nitta Co., Ltd., Osaka, Japan) intraoperatively, and the results were compared with the alignment of the femoral component after TKA.
Results: The PF contact stress was not correlated with sagittal and coronal alignment of the femoral component and patellar tracking, whereas rotational alignment of the femoral component was negatively correlated with PF contact stress (r = -0.718, p < 0.01).
Conclusions: Regarding the alignment of the femoral component, only the rotational alignment of the femoral component was correlated with PF contact stress. PF contact stress decreased more as the femoral component rotated more externally.
Level of evidence: Case control study, Level III.
Keywords: Patellofemoral contact stress; Patellofemoral joint; Rotational alignment of the femoral component; Total knee arthroplasty.