Biomechanical Analysis of Anterior Advancement of the Tibial Tuberosity
Resource
JOURNAL OF APPLIED BIOMECHANICS v.9 n.1 pp.1-14
Journal
JOURNAL OF APPLIED BIOMECHANICS
Journal Volume
v.9
Journal Issue
n.1
Pages
1-14
Date Issued
1994
Date
1994
Author(s)
CHENG, CHENG-KUNG
YAO, NAN-KUANG
LIU, HWA-CHANG
Abstract
The objective of this study is to evaluate the surgical outcome of anterior displacement of the tibial tuberosity ( Maquet procedure) for reducing patellofemoral joint force. The in vivo experimental knee joint geometric data with a biomechanical model were used to simulate the Maquet precedure. Six healthy young adults performed weight-bearing knee flexion -extension by ascanding a one-step stair. Dynamic X-ray images of the knee were continuously recorded by a video-fluoroscopic system. These Xray images were analyzed on a computderized digitizing system to get the knee joint geometric data. Based on the continuous in vivo geometric data, computer surgery simulation was studied on 6 right knees with advancement of 3,5,10,15, and 20 degrees of tlte patellar tendon insertion. Evaluation of the simulation consequences from a biomechanical view point showed that the Maquet procedure reduced the patellofemoral joint reaction force only up to 20% at 90 degrees of knee flexion angle. The patellofemoral joint reaction force had 50% reduction only when the knee flexion angle was less than 20 degrees, and only when patellar tendon was moved outwaeds by 15 or 20 degrees. This represented nearly one inch of the anterior displacement of the tibial tuberosity. The results also showed that the Maquet procedure would decrease up to 20% of the force transmission efficiency of the patellofemoral mechanism, which would cause the mechanical consequences of the operation to be only minor at knee flexion angles greater than 20 degrees. These findings suggest that the Maquet procedure is only favorable to elderly or less active patients assuming knee flexion angle activities.#0703#