{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T12:18:35Z","timestamp":1769170715898,"version":"3.49.0"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2012,1,3]],"date-time":"2012-01-03T00:00:00Z","timestamp":1325548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Complications of the patellofemoral (PF) joint remain a common cause for revision of total knee replacements. PF complications, such as patellar maltracking, subluxation, and implant failure, have been linked to femoral and patellar component alignment. In this study, a dynamic finite element model of an implanted PF joint was applied in conjunction with a probabilistic simulation to establish relationships between alignment parameters and PF kinematics, contact mechanics, and internal stresses. Both traditional sensitivity analysis and a coupled probabilistic and principal component analysis approach were applied to characterize relationships between implant alignment and resulting joint mechanics. Critical alignment parameters, and combinations of parameters, affecting PF mechanics were identified for three patellar designs (dome, modified dome, and anatomic). Femoral internal\u2013external (I\u2010E) alignment was identified as a critical alignment factor for all component designs, influencing medial\u2013lateral contact force and anterior\u2013posterior translation. The anatomic design was sensitive to patellar flexion\u2013extension (F\u2010E) alignment, while the dome, as expected, was less influenced by rotational alignment, and more by translational position. The modified dome was sensitive to a combination of superior\u2013inferior, F\u2010E, and I\u2010E alignments. Understanding the relationships and design\u2010specific dependencies between alignment parameters can aid preoperative planning, and help focus instrumentation design on those alignment parameters of primary concern. \u00a9 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. 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