An increased stress in the patella due to the implantation of a patellar button may also be another potential source of pain
in total knee arthroplasty patients. This study assessed the location inside the patella having largest stress change after
implantation of an ultra high molecular polyethylene patella button. Finite elements models of the patellae before and after
implantation of patellar button were created. Experimentally determined spring constants of muscles and ligaments, and patellofemoral
contacting loads were applied to the models at 30°, 60°, and 90° of knee flexion. The Von Mises stress of the intact patella
decreased with increased knee flexion, while that of implanted patella increased. Also, the stress range in the implanted
patella was 3~9 times higher than in the intact one. The highly stressed region of the intact patella moved proximally with
higher knee flexion angles, while that of the implanted model stayed near the central anterior patella. At 90° of knee flexion,
the stress in the anterodistal patella increased considerably after implantation of a patella button so that the anterodistal
patella may be susceptible to be painful source after the total knee replacement.
Keywords Patella - Stress - Pain - Patella button - Knee - Resurfacing - Total knee arthroplasty