Modifica del taglio chirurgico in un'operazione di artroplastica totale di ginocchio finalizzata alla riduzione della pressione patellofemorale e spunti per un nuovo modello di protesi high-flex. = Modification of the surgical cut in a total knee arthroplasty operation aimed at reducing the patellofemoral pressure and hints for a new high-flex prosthesis model.

Total knee arthroplasty is nowadays a consolidated practice, the survival rate of the implant in the 10 year is over 90%. One of the main drawbacks that can be found even in the case of a perfectly successful implant is represented by a limitation in the maximum flexion range that the prosthetic joint can guarantee; the prosthesis of the patellofemoral component causes a stiffening in the extensor mechanism of the knee which is followed by a reduction of the flexion range. In this study the patellofemoral stresses were determined in the case of standard knee arthroplasty and in the case of implants with a notching on the anterior femur. Subsequently a possible variation in the surgical cut of the distal femur was considered, with associated modification in the angulation of the anterior part of the prosthesis; the purpose was to reduce the patellofemoral stresses at high flexions. The changes made to both the surgical cut and the prosthesis should help to maximize the maximum flexion angle that the prosthetic knee can withstand without causing discomfort to the patient.