Biomechanical behaviour of cancellous bone on patellofemoral arthroplasty with journey prosthesis : a finite element study

Abstract

Isolated patellofemoral (PF) arthritis of the knee is a common cause of anterior knee pain and disability. Patellofemoral arthroplasty (PFA) is a bone conserving solution for patients with PF degeneration. Failure mechanisms of PFA include growing tibiofemoral arthritis and loosening of components. The implant loosening can be associated with bone resorption, or fatigue-failure of bone by overload. This research work aims at determining the structural effects of the implantation of PF prosthesis Journey PFJ (Smith&Nephew, USA) on femur cancellous bone. For this purpose, the finite element (FE) method is considered to perform computational simulations for different conditions, such as well-fixed and loosening scenarios. From the global results obtained, in the well-fixed scenario, a strain decrease on cancellous bone was noticed, which can be related to bone resorption. In the loosening scenario, when the cement layer becomes inefficient, a significant increase of cancellous bone strain was observed, which can be associated with bone fatigue-failure. These strain changes suggest a weakness of the femur after PFA.