Evaluation of Patellar Contact Pressure Changes after Static versus Dynamic Medial Patellofemoral Ligament Reconstructions Using a Finite Element Model
Abstract
:1. Introduction
2. Methods
2.1. Parametric FE Model of the PFJ
2.2. MPFLr Techniques
2.3. Simulation of the Different Surgical Techniques
3. Results
3.1. Static Anatomical Technique
3.2. Dynamic MPFLr Techniques
4. Discussion
4.1. Clinical Relevance
4.2. Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Material Properties | ||
---|---|---|
Stiffness (N/mm) | Poisson Ratio | |
Quadriceps Tendon (QT) | 1350 | 0.3 |
Patellar Tendon (PT) | 2000 | 0.3 |
Lateral Retinaculum (LR) | 2 | 0.3 |
Native Medial Patellofemoral Ligament (MPFL) | 12 | 0.3 |
MPFL Reconstruction (Semitendinosus Autograft) | 100 | 0.3 |
MPFL Reconstruction (Gracilis Autograft) | 80 | 0.3 |
MQTFL Reconstruction (Semitendinosus Autograft) | 100 | 0.3 |
MQTFL Reconstruction (Posterior Tibial Allograft) | 513 | 0.3 |
Anatomic MPFLr (STATIC) | MPFLr Using the AMT as a Pulley (Superior Bundle) (DYNAMIC) | MPFLr Using the AMT as a Pulley (Inferior Bundle) (DYNAMIC) | MQFTLr (DYNAMIC) | |
---|---|---|---|---|
Flexion Angle (°) | Length (mm) | Length (mm) | Length (mm) | Length (mm) |
0 | 60.2 + | 61.1 + | 58.3 + | 65 + |
30 | 57.9 + | 60.9 + | 60.1 + | 63 + |
40 | 57.7 | 60.8 | 60.8 | 62.7 |
60 | 57.3 * | 60.7 * | 62.1 * | 62 * |
90 | 55.6 * | 60.4 * | 62.2 * | 62 * |
120 | 50.7 * | 55.8 * | 57 * | 62 * |
Ligament Status | Flexion Angle (°) | Maximum MPFL Stress (MPa) | Maximum LR Stress (MPa) |
---|---|---|---|
INTACT MPFL | 0 | 8.85 | 1.52 |
30 | 0.78 | 0.15 | |
ANATOMIC MPFLr Semitendinosus autograft | 0 | 74.72 | 1.51 |
30 | 6.55 | 0.14 | |
ANATOMIC MPFLr Gracilis autograft | 0 | 58.78 | 1.51 |
30 | 5.12 | 0.14 | |
MPFLr with AMT as a Pulley Semitendinosus autograft | 0 | 7.11 | 0.15 |
30 | 2.53 | 0.05 | |
MPFLr with AMT as a Pulley Gracilis autograft | 0 | 6.35 | 0.15 |
30 | 2.10 | 0.05 | |
MQTFLr Semitendinosus autograft | 0 | 66.70 | 1.42 |
30 | 9.36 | 0.23 | |
MQTFLr Posterior Tibial allograft | 0 | 100.80 | 1.42 |
30 | 49.76 | 0.23 |
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Sanchis-Alfonso, V.; Ginovart, G.; Alastruey-López, D.; Montesinos-Berry, E.; Monllau, J.C.; Alberich-Bayarri, A.; Pérez, M.A. Evaluation of Patellar Contact Pressure Changes after Static versus Dynamic Medial Patellofemoral Ligament Reconstructions Using a Finite Element Model. J. Clin. Med. 2019, 8, 2093. https://doi.org/10.3390/jcm8122093
Sanchis-Alfonso V, Ginovart G, Alastruey-López D, Montesinos-Berry E, Monllau JC, Alberich-Bayarri A, Pérez MA. Evaluation of Patellar Contact Pressure Changes after Static versus Dynamic Medial Patellofemoral Ligament Reconstructions Using a Finite Element Model. Journal of Clinical Medicine. 2019; 8(12):2093. https://doi.org/10.3390/jcm8122093
Chicago/Turabian StyleSanchis-Alfonso, Vicente, Gerard Ginovart, Diego Alastruey-López, Erik Montesinos-Berry, Joan Carles Monllau, Angel Alberich-Bayarri, and María Angeles Pérez. 2019. "Evaluation of Patellar Contact Pressure Changes after Static versus Dynamic Medial Patellofemoral Ligament Reconstructions Using a Finite Element Model" Journal of Clinical Medicine 8, no. 12: 2093. https://doi.org/10.3390/jcm8122093