Finite Element Analysis of Patellofemoral Contact Pressure with Varying Fixation of Transverse Patella Fractures

Background:. Understanding patellofemoral contact pressure is crucial for knee biomechanics, as abnormalities can lead to joint issues. This study investigates the changes in contact pressure after surgical fixation of patellar fractures. Methods:. Finite element model of the knee was created using...

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Main Authors: Farid Amirouche, PhD, Majd Mzeihem, MD, Jasper Hoag, BA, Rohan Wangikar, BS, Jason Koh, MD, FAOA
Format: Article
Language:English
Published: Wolters Kluwer 2025-09-01
Series:JBJS Open Access
Online Access:http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.25.00032
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author Farid Amirouche, PhD
Majd Mzeihem, MD
Jasper Hoag, BA
Rohan Wangikar, BS
Jason Koh, MD, FAOA
author_facet Farid Amirouche, PhD
Majd Mzeihem, MD
Jasper Hoag, BA
Rohan Wangikar, BS
Jason Koh, MD, FAOA
author_sort Farid Amirouche, PhD
collection DOAJ
description Background:. Understanding patellofemoral contact pressure is crucial for knee biomechanics, as abnormalities can lead to joint issues. This study investigates the changes in contact pressure after surgical fixation of patellar fractures. Methods:. Finite element model of the knee was created using cadaveric data on transverse patellar fractures. Models were analyzed and evaluated at 0°, 45°, and 90° flexion under quadriceps force to assess peak pressure, contact pattern, and pressure irregularity. Results:. The plate and wire fixation models exhibited distinct stress distribution patterns at 45° and 90° flexion angles. At 45°, the plate model had a higher peak stress (6.14 MPa) in a 21.0-mm ovular contact area, while the wire model had lower peak stress (2.42 MPa) in a smaller, more fragmented region. At 90°, the plate model exhibited concentrated stress (13.26 MPa) in a heart-shaped area, whereas the wire model had 3 dispersed stress points (9.88 MPa) over a broader surface. These findings highlight the plate model's greater stress concentration and the wire model’s more irregular distribution of stress. At 0°, the plate model exhibited minimal contact pressure compared with the wire model, with a pressure of 6.67 MPa. Conclusion:. The plate model better preserves patellofemoral biomechanics, potentially reducing complications and improving long-term outcomes. Further research is needed to confirm its superiority as a fixation method. Clinical Relevance:. Although the prevalence of patellar fractures remains high, the gold-standard method for surgical fixation has a postoperative complication rate as high as 52.5%. Addressing the lack of understanding surrounding patellofemoral contact pressure in this scenario is an essential step toward improving outcomes for these patients.
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spelling doaj-art-6b992eaf06144e478a82df4c26639b102025-08-20T03:36:18ZengWolters KluwerJBJS Open Access2472-72452025-09-0110310.2106/JBJS.OA.25.00032JBJSOA2500032Finite Element Analysis of Patellofemoral Contact Pressure with Varying Fixation of Transverse Patella FracturesFarid Amirouche, PhD0Majd Mzeihem, MD1Jasper Hoag, BA2Rohan Wangikar, BS3Jason Koh, MD, FAOA41 Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, Illinois1 Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, Illinois1 Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, Illinois1 Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, Illinois2 Department of Orthopaedic Surgery, Northshore University Health System, An Affiliate of the University of Chicago Pritzker School of Medicine. Skokie, IllinoisBackground:. Understanding patellofemoral contact pressure is crucial for knee biomechanics, as abnormalities can lead to joint issues. This study investigates the changes in contact pressure after surgical fixation of patellar fractures. Methods:. Finite element model of the knee was created using cadaveric data on transverse patellar fractures. Models were analyzed and evaluated at 0°, 45°, and 90° flexion under quadriceps force to assess peak pressure, contact pattern, and pressure irregularity. Results:. The plate and wire fixation models exhibited distinct stress distribution patterns at 45° and 90° flexion angles. At 45°, the plate model had a higher peak stress (6.14 MPa) in a 21.0-mm ovular contact area, while the wire model had lower peak stress (2.42 MPa) in a smaller, more fragmented region. At 90°, the plate model exhibited concentrated stress (13.26 MPa) in a heart-shaped area, whereas the wire model had 3 dispersed stress points (9.88 MPa) over a broader surface. These findings highlight the plate model's greater stress concentration and the wire model’s more irregular distribution of stress. At 0°, the plate model exhibited minimal contact pressure compared with the wire model, with a pressure of 6.67 MPa. Conclusion:. The plate model better preserves patellofemoral biomechanics, potentially reducing complications and improving long-term outcomes. Further research is needed to confirm its superiority as a fixation method. Clinical Relevance:. Although the prevalence of patellar fractures remains high, the gold-standard method for surgical fixation has a postoperative complication rate as high as 52.5%. Addressing the lack of understanding surrounding patellofemoral contact pressure in this scenario is an essential step toward improving outcomes for these patients.http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.25.00032
spellingShingle Farid Amirouche, PhD
Majd Mzeihem, MD
Jasper Hoag, BA
Rohan Wangikar, BS
Jason Koh, MD, FAOA
Finite Element Analysis of Patellofemoral Contact Pressure with Varying Fixation of Transverse Patella Fractures
JBJS Open Access
title Finite Element Analysis of Patellofemoral Contact Pressure with Varying Fixation of Transverse Patella Fractures
title_full Finite Element Analysis of Patellofemoral Contact Pressure with Varying Fixation of Transverse Patella Fractures
title_fullStr Finite Element Analysis of Patellofemoral Contact Pressure with Varying Fixation of Transverse Patella Fractures
title_full_unstemmed Finite Element Analysis of Patellofemoral Contact Pressure with Varying Fixation of Transverse Patella Fractures
title_short Finite Element Analysis of Patellofemoral Contact Pressure with Varying Fixation of Transverse Patella Fractures
title_sort finite element analysis of patellofemoral contact pressure with varying fixation of transverse patella fractures
url http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.25.00032
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