Knee injury is a common medical issue. A full understanding of the kinematics and mechanical properties of knees following total\nknee arthroplasty (TKA) repair utilizing patellar replacement (only the base of the patella is replaced) versus patellar retaining\nsurgical techniques is still lacking. In the current paper, we investigated magnetic resonance (MR) imaging data from knees\nrepaired by these two methods and evaluated total knee models created using imaging reconstruction technology that simulated\ngait conditions. Results revealed that patellar replacement had little influence on tibiofemoral kinematics, although the tibia-surface\nequivalent stress increased slightly. By contrast, patellar replacement had a significant influence on the patellofemoral joint; patellar\ninternal rotation, external rotation, and medial-lateral translation were all increased. Moreover, the stress distribution on patellar\nprostheses was altered, resulting in an increased surface maximal equivalent stress on the corresponding area. Moreover, during\nthe gait cycle, we found that the area with maximal equivalent stress shifted its position. Finally, the patellofemoral joint showed\ndecreased motion stability. From the view of kinematics and mechanics, this paper suggests that patella should be retained during\nTKA if it is possible.The present study presented approaches and technologies for evaluating kinematics and mechanical properties\nof total knee joint after TKA under gait loads.
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