Femoral maltorsion influences both patellofemoral and tibiofemoral contact pressures. A biomechanical evaluation

Introduction/objectives: To investigate the effect of femoral maltorsion on both the patellofemoral and the tibiofemoral contact pressures. Methods: Experimental biomechanical study on 10 embalmed human cadaveric knees (mean age 40.2 years ​± ​9.5). Krackow sutures were placed in the vastus medialis...

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Autores: Morales Avalos, Rodolfo|||0000-0003-0720-5554, Chiappe, Caterina|||0000-0002-4710-1461, Ceniceros-Cantú, Christopher, Cienfuegos-Jiménez, Gerardo, Garza López, Judith, Ortiz-García, Carlos Fernando, Elizondo-Omaña, Rodrigo E.|||0000-0002-8017-2640, Guzmán López, Santos|||0000-0003-4100-1360, Monllau García, Joan Carles|||0000-0002-2418-4874, Sanchis-Alfonso, Vicente|||0000-0002-9191-796X
Formato: artículo
Fecha de publicación:2025
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:320204
Acesso em linha:https://ddd.uab.cat/record/320204
https://dx.doi.org/urn:doi:10.1016/j.jisako.2025.100866
Access Level:acceso abierto
Palavra-chave:Femoral maltorsion
Femoral osteotomy
Knee osteoarthritis
Biomechanics
Patellofemoral pressures
Tibiofemoral pressures
Malalignment
Anteversion
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spelling Femoral maltorsion influences both patellofemoral and tibiofemoral contact pressures. A biomechanical evaluationMorales Avalos, Rodolfo|||0000-0003-0720-5554Morales Avalos, Rodolfo|||0000-0003-0720-5554Chiappe, Caterina|||0000-0002-4710-1461Ceniceros-Cantú, ChristopherCienfuegos-Jiménez, GerardoGarza López, JudithOrtiz-García, Carlos FernandoElizondo-Omaña, Rodrigo E.|||0000-0002-8017-2640Guzmán López, Santos|||0000-0003-4100-1360Monllau García, Joan Carles|||0000-0002-2418-4874Sanchis-Alfonso, Vicente|||0000-0002-9191-796XFemoral maltorsionFemoral osteotomyKnee osteoarthritisBiomechanicsPatellofemoral pressuresTibiofemoral pressuresMalalignmentAnteversionIntroduction/objectives: To investigate the effect of femoral maltorsion on both the patellofemoral and the tibiofemoral contact pressures. Methods: Experimental biomechanical study on 10 embalmed human cadaveric knees (mean age 40.2 years ​± ​9.5). Krackow sutures were placed in the vastus medialis, vastus lateralis, rectus femoris, vastus intermedius, and hamstrings. A custom-made test apparatus capable of independently loading the quadriceps and hamstring muscle groups and providing ground reaction forces during a simulated squat maneuver and under direct axial compression loading was used. A ground reaction force of 1000 ​N was applied to the distal tibia and scaled loads of 218N and 80N were applied to the quadriceps and hamstrings, respectively, at 0°, 30°, 60°, and 90° of flexion. Pressure measurements were performed by intra-articularly placed sensors (77.3 ​× ​77.3 ​mm, SFM6000CXR2 Sensor) and using Snowforce 3 interpretation software. After testing of the native knee, supracondylar femoral osteotomy was performed. Pressure measurements were again made in each knee compartment, at each of the degrees of rotation evaluated. Results: Medial aspect of the patella showed an increase of contact pressure with external femoral rotation from 10° to 30° compared with 0°. The strongest effect was measured at 30° of knee flexion (p ​= ​0.005) with 30° of external rotation (p ​= ​0.004) with a value of 2.140 ​± ​0.1832 Mpa. With internal femoral rotation there is an increment of contact pressure in the lateral aspect of the patella, with the strongest effect at 30° of flexion (p ​= ​0.0059) with 30° of internal rotation (p ​= ​0.0002) with a value of 1.352 ​± ​0.08166 Mpa. The medial tibiofemoral contact pressure showed an increment from 10° to 30° of external rotation compared with the native state. The highest pressure was shown at 90° of knee flexion (p ​= ​0.0006) and 30° of external rotation (p ​= ​0.004) with a value of 1.636 ​± ​0.01878 Mpa. The lateral tibiofemoral contact pressure increased compared with the control group more with internal than with external rotation. The highest pressure was shown at 90° of flexion (p ​< ​0.0001) and 30° of internal rotation (p ​< ​0.0001) with a value of 1.432 ​± ​0.004051 Mpa. Conclusions: Femoral malrotation influences patellofemoral and tibiofemoral contact pressure. Femoral external rotation may result in worse knee biomechanics than internal rotation. Level of evidence: III. 22025-01-0120252025-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/320204https://dx.doi.org/urn:doi:10.1016/j.jisako.2025.100866reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3202042026-06-06T12:50:31Z
dc.title.none.fl_str_mv Femoral maltorsion influences both patellofemoral and tibiofemoral contact pressures. A biomechanical evaluation
title Femoral maltorsion influences both patellofemoral and tibiofemoral contact pressures. A biomechanical evaluation
spellingShingle Femoral maltorsion influences both patellofemoral and tibiofemoral contact pressures. A biomechanical evaluation
Morales Avalos, Rodolfo|||0000-0003-0720-5554
Femoral maltorsion
Femoral osteotomy
Knee osteoarthritis
Biomechanics
Patellofemoral pressures
Tibiofemoral pressures
Malalignment
Anteversion
title_short Femoral maltorsion influences both patellofemoral and tibiofemoral contact pressures. A biomechanical evaluation
title_full Femoral maltorsion influences both patellofemoral and tibiofemoral contact pressures. A biomechanical evaluation
title_fullStr Femoral maltorsion influences both patellofemoral and tibiofemoral contact pressures. A biomechanical evaluation
title_full_unstemmed Femoral maltorsion influences both patellofemoral and tibiofemoral contact pressures. A biomechanical evaluation
title_sort Femoral maltorsion influences both patellofemoral and tibiofemoral contact pressures. A biomechanical evaluation
dc.creator.none.fl_str_mv Morales Avalos, Rodolfo|||0000-0003-0720-5554
Morales Avalos, Rodolfo|||0000-0003-0720-5554
Chiappe, Caterina|||0000-0002-4710-1461
Ceniceros-Cantú, Christopher
Cienfuegos-Jiménez, Gerardo
Garza López, Judith
Ortiz-García, Carlos Fernando
Elizondo-Omaña, Rodrigo E.|||0000-0002-8017-2640
Guzmán López, Santos|||0000-0003-4100-1360
Monllau García, Joan Carles|||0000-0002-2418-4874
Sanchis-Alfonso, Vicente|||0000-0002-9191-796X
author Morales Avalos, Rodolfo|||0000-0003-0720-5554
author_facet Morales Avalos, Rodolfo|||0000-0003-0720-5554
Chiappe, Caterina|||0000-0002-4710-1461
Ceniceros-Cantú, Christopher
Cienfuegos-Jiménez, Gerardo
Garza López, Judith
Ortiz-García, Carlos Fernando
Elizondo-Omaña, Rodrigo E.|||0000-0002-8017-2640
Guzmán López, Santos|||0000-0003-4100-1360
Monllau García, Joan Carles|||0000-0002-2418-4874
Sanchis-Alfonso, Vicente|||0000-0002-9191-796X
author_role author
author2 Chiappe, Caterina|||0000-0002-4710-1461
Ceniceros-Cantú, Christopher
Cienfuegos-Jiménez, Gerardo
Garza López, Judith
Ortiz-García, Carlos Fernando
Elizondo-Omaña, Rodrigo E.|||0000-0002-8017-2640
Guzmán López, Santos|||0000-0003-4100-1360
Monllau García, Joan Carles|||0000-0002-2418-4874
Sanchis-Alfonso, Vicente|||0000-0002-9191-796X
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Femoral maltorsion
Femoral osteotomy
Knee osteoarthritis
Biomechanics
Patellofemoral pressures
Tibiofemoral pressures
Malalignment
Anteversion
topic Femoral maltorsion
Femoral osteotomy
Knee osteoarthritis
Biomechanics
Patellofemoral pressures
Tibiofemoral pressures
Malalignment
Anteversion
description Introduction/objectives: To investigate the effect of femoral maltorsion on both the patellofemoral and the tibiofemoral contact pressures. Methods: Experimental biomechanical study on 10 embalmed human cadaveric knees (mean age 40.2 years ​± ​9.5). Krackow sutures were placed in the vastus medialis, vastus lateralis, rectus femoris, vastus intermedius, and hamstrings. A custom-made test apparatus capable of independently loading the quadriceps and hamstring muscle groups and providing ground reaction forces during a simulated squat maneuver and under direct axial compression loading was used. A ground reaction force of 1000 ​N was applied to the distal tibia and scaled loads of 218N and 80N were applied to the quadriceps and hamstrings, respectively, at 0°, 30°, 60°, and 90° of flexion. Pressure measurements were performed by intra-articularly placed sensors (77.3 ​× ​77.3 ​mm, SFM6000CXR2 Sensor) and using Snowforce 3 interpretation software. After testing of the native knee, supracondylar femoral osteotomy was performed. Pressure measurements were again made in each knee compartment, at each of the degrees of rotation evaluated. Results: Medial aspect of the patella showed an increase of contact pressure with external femoral rotation from 10° to 30° compared with 0°. The strongest effect was measured at 30° of knee flexion (p ​= ​0.005) with 30° of external rotation (p ​= ​0.004) with a value of 2.140 ​± ​0.1832 Mpa. With internal femoral rotation there is an increment of contact pressure in the lateral aspect of the patella, with the strongest effect at 30° of flexion (p ​= ​0.0059) with 30° of internal rotation (p ​= ​0.0002) with a value of 1.352 ​± ​0.08166 Mpa. The medial tibiofemoral contact pressure showed an increment from 10° to 30° of external rotation compared with the native state. The highest pressure was shown at 90° of knee flexion (p ​= ​0.0006) and 30° of external rotation (p ​= ​0.004) with a value of 1.636 ​± ​0.01878 Mpa. The lateral tibiofemoral contact pressure increased compared with the control group more with internal than with external rotation. The highest pressure was shown at 90° of flexion (p ​< ​0.0001) and 30° of internal rotation (p ​< ​0.0001) with a value of 1.432 ​± ​0.004051 Mpa. Conclusions: Femoral malrotation influences patellofemoral and tibiofemoral contact pressure. Femoral external rotation may result in worse knee biomechanics than internal rotation. Level of evidence: III.
publishDate 2025
dc.date.none.fl_str_mv 2
2025-01-01
2025
2025-01-01
dc.type.none.fl_str_mv Article
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VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
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https://dx.doi.org/urn:doi:10.1016/j.jisako.2025.100866
url https://ddd.uab.cat/record/320204
https://dx.doi.org/urn:doi:10.1016/j.jisako.2025.100866
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
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instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
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