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https://www.readbyqxmd.com/read/28089467/the-evolution-of-implant-design-decreases-the-incidence-of-lateral-release-in-primary-total-knee-arthroplasty
#1
Jonathan E Webb, Heidi Y Yang, Jamie E Collins, Elena Losina, Thomas S Thornhill, Jeffrey N Katz
BACKGROUND: Appropriate balancing of the patellofemoral joint (PFJ) using a lateral release can help to prevent patellar instability in total knee arthroplasty (TKA). Contemporary total knee implant designs are characterized by enhanced trochlear geometry more similar to native knee anatomy to minimize instability and reduce utilization of a lateral release. METHODS: We retrospectively reviewed consecutive TKA cases from a single senior surgeon's practice with 3 successive total knee designs: the Press-Fit Condylar (PFC), the Sigma, and the ATTUNE (DePuy, Warsaw, IN)...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28087396/influence-of-coronal-bowing-on-the-lower-alignment-and-the-positioning-of-component-in-navigation-and-conventional-total-knee-arthroplasty
#2
Hideo Kobayashi, Yasushi Akamatsu, Ken Kumagai, Yoshihiro Kusayama, Masato Aratake, Tomoyuki Saito
BACKGROUND: Coronal alignment is an important factor for the function and longevity of total knee arthroplasty (TKA). Coronal bowing of the lower extremity is common among Asians and it may pose a risk for malalignment of the lower leg and malposition of component. HYPOTHESIS: We hypothesized that coronal bowing itself has a risk for malalignment of the lower leg and malposition of femoral / tibial components and that navigation TKA is beneficial for patients with coronal bowing...
January 10, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28077396/the-effects-of-kinematically-aligned-total-knee-arthroplasty-on-stress-at-the-medial-tibia-a-case-study-for-varus-knee
#3
S Nakamura, Y Tian, Y Tanaka, S Kuriyama, H Ito, M Furu, S Matsuda
OBJECTIVES: Little biomechanical information is available about kinematically aligned (KA) total knee arthroplasty (TKA). The purpose of this study was to simulate the kinematics and kinetics after KA TKA and mechanically aligned (MA) TKA with four different limb alignments. MATERIALS AND METHODS: Bone models were constructed from one volunteer (normal) and three patients with three different knee deformities (slight, moderate and severe varus). A dynamic musculoskeletal modelling system was used to analyse the kinematics and the tibiofemoral contact force...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28072630/bracing-of-the-reconstructed-and-osteoarthritic-knee-during-high-dynamic-load-tasks
#4
Harvi F Hart, Kay M Crossley, Natalie J Collins, David C Ackland
PURPOSE: Lateral compartment osteoarthritis accompanied by abnormal knee biomechanics are frequently reported in individuals with knee osteoarthritis after anterior cruciate ligament reconstruction (ACLR). The aim of this study was to evaluate changes in knee biomechanics produced by an adjusted and unadjusted varus knee brace during high dynamic loading activities in individuals with lateral knee osteoarthritis after ACLR and valgus malalignment. METHODS: Nineteen participants who had undergone ACLR 5 to 20 years previously and had symptomatic and radiographic lateral knee osteoarthritis with valgus malalignment were assessed...
January 9, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28068520/impact-loading-following-quadriceps-strength-training-in-individuals-with-medial-knee-osteoarthritis-and-varus-alignment
#5
Crystal O Kean, Rana S Hinman, Tim V Wrigley, Boon-Whatt Lim, Kim L Bennell
BACKGROUND: Greater impact loading at initial contact is postulated to play a role in the progression of osteoarthritis. Quadriceps weakness is common in individuals with knee osteoarthritis and may contribute to high impact loading. The purpose of this study was to examine the effects of quadriceps strengthening on impact loading parameters. METHODS: Data from 97 individuals with knee osteoarthritis who participated in a randomized clinical trial examining effects of a 12-week quadriceps strengthening program was used to conduct this secondary exploratory analysis...
January 4, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28067099/dynamic-rsa-for-the-evaluation-of-inducible-micromotion-of-oxford-uka-during-step-up-and-step-down-motion
#6
Kristian Horsager, Bart L Kaptein, Lone RøMer, Peter B Jørgensen, Maiken Stilling
Background and purpose - Implant inducible micromotions have been suggested to reflect the quality of the fixation interface. We investigated the usability of dynamic RSA for evaluation of inducible micromotions of the Oxford Unicompartmental Knee Arthroplasty (UKA) tibial component, and evaluated factors that have been suggested to compromise the fixation, such as fixation method, component alignment, and radiolucent lines (RLLs). Patients and methods - 15 patients (12 men) with a mean age of 69 (55-86) years, with an Oxford UKA (7 cemented), were studied after a mean time in situ of 4...
January 9, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28063645/anisotropy-and-inter-condyle-heterogeneity-of-cartilage-under-large-strain-shear
#7
Stephany Santos, Franz Maier, David M Pierce
We were the first to examine the mechanical responses of skeletally mature bovine femoral cartilage under large-strain simple shear (up to ±20%) using a multiaxial shear testing device. Since shear loading is critical in both tissue failure and chondrocyte responses, we aimed to probe (1) anisotropy with respect to the split-line direction (principal alignment of the collagen fibers near the articulating surface), (2) heterogeneity between femoral condyles, and (3) the influence of local cartilage thickness...
December 30, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/28061849/do-size-shape-and-alignment-parameters-of-the-femoral-condyle-affect-the-trochlear-groove-tracking-a-morphometric-study-based-on-3d-computed-tomography-models-in-chinese-people
#8
Zhe Du, Shichang Chen, Mengning Yan, Bing Yue, Yiming Zeng, You Wang
BACKGROUND: Our study aimed to investigate whether geometrical features (size, shape, or alignment parameters) of the femoral condyle affect the morphology of the trochlear groove. METHODS: Computed tomography models of 195 femurs (97 and 98 knees from male and female subjects, respectively) were reconstructed into three-dimensional models and categorised into four types of trochlear groove morphology based on the position of the turning point in relation to the mechanical axis (types 45°, 60°, 75°, and 90°)...
January 6, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28057348/lower-extremity-control-during-turns-initiated-with-and-without-hip-external-rotation
#9
Antonia M Zaferiou, Henryk Flashner, Rand R Wilcox, Jill L McNitt-Gray
The pirouette turn is often initiated in neutral and externally rotated hip positions by dancers. This provides an opportunity to investigate how dancers satisfy the same mechanical objectives at the whole-body level when using different leg kinematics. The purpose of this study was to compare lower extremity control strategies during the turn initiation phase of pirouettes performed with and without hip external rotation. Skilled dancers (n=5) performed pirouette turns with and without hip external rotation...
December 29, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/28053387/reference-axes-for-optimal-femoral-rotational-alignment-in-varus-osteoarthritic-indian-knees-a-ct-based-study
#10
A V Gurava Reddy, Rajat Kumar Mathur, Aakash Mugalur, Krishna Kiran Eachempati, Anil Reddy
BACKGROUND: Optimal rotational alignment of femoral component is important for longevity and success of total knee replacement. Whiteside line (WL), posterior condylar axis (PCA) and femoral transepicondylar axis are various intra-operative landmarks to guide femoral rotation. Each of these has its pros and cons. The aims of our study were to assess the relationship of posterior condylar axis and the antero-posterior axis of femur with the surgical epicondylar axis and evaluate whether degree of deformity or severity of osteoarthritis alters the rotational alignment of the femur when posterior condylar axis is taken as a reference...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28053258/ankle-joint-pressure-changes-in-high-tibial-and-distal-femoral-osteotomies-a-cadaver-study
#11
F Krause, A Barandun, G Klammer, I Zderic, B Gueorguiev, T Schmid
AIMS: To assess the effect of high tibial and distal femoral osteotomies (HTO and DFO) on the pressure characteristics of the ankle joint. MATERIALS AND METHODS: Varus and valgus malalignment of the knee was simulated in human cadaver full-length legs. Testing included four measurements: baseline malalignment, 5° and 10° re-aligning osteotomy, and control baseline malalignment. For HTO, testing was rerun with the subtalar joint fixed. In order to represent half body weight, a 300 N force was applied onto the femoral head...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28050572/comparison-of-a-novel-weightbearing-cone-beam-computed-tomography-scanner-versus-a-conventional-computed-tomography-scanner-for-measuring-patellar-instability
#12
John Marzo, Melissa Kluczynski, Anthony Notino, Leslie Bisson
BACKGROUND: Conventional computed tomography (CT) images are routinely used for diagnosing patellofemoral instability and are obtained with the patient in a supine position, nonweightbearing, with the knee in full extension, and with leg muscles relaxed. A new portable extremity cone beam CT (CBCT) scanner has been developed that may allow for more accurate diagnosis, as imaging can be performed with the patient standing, the knee flexed, and with leg muscles active. PURPOSE/HYPOTHESIS: The purpose of this study was to compare CT measurements of patellar alignment on a prototype scanner versus conventional scanner in patients with known patellar instability...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28047444/mo-fg-campus-jep3-02-a-novel-setup-approach-to-improve-c-spine-curvature-reproducibility-for-head-and-neck-radiotherapy-using-optical-surface-imaging-with-two-regions-of-interest
#13
K Ryan, M Gil, C Della Biancia, G Li
PURPOSE: To develop a novel approach to improve cervical spine (c-spine) curvature reproducibility for head and neck (HN) patients using optical surface imaging (OSI) with two regions of interests (ROIs). METHODS: The OSI-guided, two-step setup procedure requires two ROIs: ROI-1 of the shoulders and ROI-2 of the face. The neck can be stretched or squeezed in superior-inferior (SI) direction using a specially-designed sliding head support. We hypothesize that when these two ROIs are aligned, the c-spine should fall into a naturally reproducible position under same setup conditions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28039023/determination-of-the-accuracy-of-navigated-kinematic-unicompartmental-knee-arthroplasty-a-2-year-follow-up
#14
Andrea L Grant, Kenji D Doma, Kaushik Hazratwala
BACKGROUND: Unicompartmental knee arthroplasty (UKA) lacks history of patient satisfaction and research addressing technique validity. The aim of this study was to determine minimally invasive navigated kinematic UKA accuracy by comparing postoperative limb alignment with preoperative stress values. METHODS: A single-center retrospective study was conducted on 53 consecutive patients (postoperative alignment: varus n = 51, valgus n = 2) who underwent computer navigation assisted UKA...
November 29, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28032709/relationship-between-patellar-tracking-and-the-screw-home-mechanism-of-tibiofemoral-joint
#15
Li-Kang Zhang, Xiao-Meng Wang, Ying-Zhen Niu, Hui-Xin Liu, Fei Wang
OBJECTIVE: To demonstrate the effect of the screw-home motion on the stability of the patellofemoral joint, and investigate its mechanism of regulation of patellar tracking. METHODS: Twenty volunteers who met the criteria were examined. All subjects had axial computed tomography (CT) scanning performed on bilateral knees at 0° and 30° of flexion. Scanning began above the femorotibial articulation and femoral trochlear groove, and moved sequentially down to the level of the anterior tibial tubercle...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28032707/surgical-technique-for-subtrochanteric-fracture-of-femur
#16
Peng-Cheng Wang, Dong Ren, Chao-Hui Song, Bing Zhou
A 56-year-old woman had fell over herself 4 h prior to her presentation to our hospital. The diagnosis was a subtrochanteric fracture of the right femur (AO-32-A3). The patient was placed in a supine position was set up on a fracture traction table after general anesthesia. The right leg was placed in abduction while the left leg was positioned so that there was flexion of the knee and hip joint. The C-arm was placed on the left side. The surgical field was sterilized and draped. Deformity and external rotation are always present for this type of fracture, so the first step was to place a joystick in the proximal fragment to correct the external rotation...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28032697/patient-specific-orthopaedic-implants
#17
REVIEW
Jack M Haglin, Adam E M Eltorai, Joseph A Gil, Stephen E Marcaccio, Juliana Botero-Hincapie, Alan H Daniels
Patient-specific orthopaedic implants are emerging as a clinically promising treatment option for a growing number of conditions to better match an individual's anatomy. Patient-specific implant (PSI) technology aims to reduce overall procedural costs, minimize surgical time, and maximize patient outcomes by achieving better biomechanical implant fit. With this commercially-available technology, computed tomography or magnetic resonance images can be used in conjunction with specialized computer programs to create preoperative patient-specific surgical plans and to develop custom cutting guides from 3-D reconstructed images of patient anatomy...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28031496/arthroscopic-transphyseal-anterior-cruciate-ligament-reconstruction-in-adolescent-athletes
#18
Luca Dei Giudici, Roberto Fabbrini, Luca Garro, Serena Arima, Antonio Gigante, Agostino Tucciarone
PURPOSE: To evaluate the 5-year outcome of arthroscopic transphyseal anterior cruciate ligament (ACL) reconstruction in 19 adolescent athletes. METHODS: 14 male and 5 female adolescent athletes aged 12 to 16 (mean, 13.9) years with Tanner stage 2 or 3 open physes underwent arthroscopic transphyseal ACL reconstruction by a single surgeon and were followed up for 5 years. Patients were evaluated using the numerical rating score (NRS) for pain, knee osteoarthritis outcome score (KOOS), International Knee Documentation Committee (IKDC) score, Tegner Activity Scale, and Lysholm Score, as well as the leg length discrepancy, femorotibial alignment, varus or valgus deformities, active and passive knee range of motion...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28031494/outcome-in-total-knee-arthroplasty-with-a-medial-lateral-balanced-versus-unbalanced-gap
#19
Ahmed Jawhar, Karolin Hutter, Hanns-Peter Scharf
PURPOSE: To evaluate the clinical outcome in 108 total knee arthroplasty (TKA) patients with a medial-lateral balanced versus unbalanced gap after a mean follow-up of 34 months. METHODS: 64 women and 44 men (mean age, 69.5 years) underwent computer-assisted TKA for osteoarthritis using a cemented fixed-bearing cruciate-retaining prosthesis. The medial-lateral gap difference (measured with the prosthesis in situ and the patella reduced) was balanced (≤2 mm) in 81 patients and unbalanced (>2 mm) in 27 patients...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28029800/patellofemoral-kinematics-and-tibial-tuberosity-trochlear-groove-distances-in-female-adolescents-with-patellofemoral-pain
#20
Victor R Carlson, Barry P Boden, Frances T Sheehan
BACKGROUND: Patellofemoral pain (PFP) is a prevalent disorder among female adolescents. Overuse is frequently cited as the cause of pain for this population. What is currently unclear, however, is if the patella demonstrates abnormal tracking patterns relative to the femoral trochlear groove in female adolescents with PFP. PURPOSE: The aim of this case-control study was to determine if abnormal patellar tracking patterns are present in female adolescents with PFP...
December 1, 2016: American Journal of Sports Medicine
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