Parametric finite element model of medial patellofemoral ligament reconstruction model development and clinical validation

Vicente Sanchis-Alfonso, Diego Alastruey-López, Gerad Ginovart, Erik Montesinos-Berry, Fabio García-Castro, Cristina Ramírez-Fuentes, Joan Carles Monllau, Angel Alberich-Bayarri, María Angeles Pérez

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Abstract

© 2019, The Author(s). Background: Currently, there is uncertainty regarding the long-term outcome of medial patellofemoral ligament reconstructions (MPFLr). Our objectives were: (1) to develop a parametric model of the patellofemoral joint (PFJ) enabling us to simulate different surgical techniques for MPFLr; (2) to determine the negative effects on the PFJ associated with each technique, which could be related to long-term deterioration of the PFJ. Methods: A finite element model of the PFJ was created based on CT data from 24 knees with chronic lateral patellar instability. Patella contact pressure and maximum MPFL-graft stress at five angles of knee flexion (0, 30, 60, 90 and 120°) were analysed in three types of MPFLr: anatomic, non-anatomic with physiometric behaviour, and non-anatomic with non-physiometric behaviour. Results: An increase in patella contact pressure was observed at 0 and 30° of knee flexion after both anatomic and non-anatomic MPFLr with physiometric behaviour. In both reconstructions, the ligament was tense between 0 and 30° of knee flexion, but at 60, 90 and 120°, it had no tension. In the third reconstruction, the behaviour was completely the opposite. Conclusion: A parametric model of the PFJ enables us to evaluate different types of MPFLr throughout the full range of motion of the knee, regarding the effect on the patellofemoral contact pressure, as well as the kinematic behaviour of the MPFL-graft and the maximum MPFL-graft stress.
Original languageEnglish
Article number32
JournalJournal of Experimental Orthopaedics
Volume6
DOIs
Publication statusPublished - 1 Dec 2019

Keywords

  • Finite element methodology
  • Medial patellofemoral ligament
  • MPFL reconstruction
  • MPFL-stress
  • Patellofemoral contact pressure
  • Patellofemoral joint

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    Sanchis-Alfonso, V., Alastruey-López, D., Ginovart, G., Montesinos-Berry, E., García-Castro, F., Ramírez-Fuentes, C., Monllau, J. C., Alberich-Bayarri, A., & Pérez, M. A. (2019). Parametric finite element model of medial patellofemoral ligament reconstruction model development and clinical validation. Journal of Experimental Orthopaedics, 6, [32]. https://doi.org/10.1186/s40634-019-0200-x