Notching of the Anterior Femoral Cortex During Total Knee Arthroplasty Characteristics That Increase Local Stresses

Notching of the anterior femoral cortex during primary total knee arthroplasty can occur when making an anterior femoral bone cut. To examine the increased stress caused by a notch, we used a validated 3-dimensional finite element model of the femur under gait loads. Three factors that affected the stress concentration were identified: First, larger notches associated with increased stress concentrations. Second, sharper notches led to …