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https://www.readbyqxmd.com/read/28646383/anterior-cruciate-ligament-graft-fixation-first-in-anterior-and-posterior-cruciate-ligament-reconstruction-best-restores-knee-kinematics
#1
Libin Zheng, Soheil Sabzevari, Brandon Marshall, Junjun Zhu, Monica A Linde, Patrick Smolinski, Freddie H Fu
PURPOSE: To evaluate the effect of different graft fixation sequences in one-stage anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction on (1) knee biomechanics and (2) tibiofemoral alignment. METHODS: Twelve porcine knees were used in this study. Five fixation sequences were performed (angle indicating knee flexion): (a) PCL at 30° and ACL at 30°, (b) PCL at 90° and ACL at 30°, (c) ACL at 30° and PCL at 30°, (d) ACL at 30° and PCL at 90°, and (e) ACL and PCL simultaneous fixation at 30°...
June 23, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28645703/mapping-of-the-anterior-tibial-profile-to-identify-accurate-reference-points-for-sagittal-alignment-of-tibial-component-in-total-knee-arthroplasty
#2
Gianluca Cinotti, Ettore Caruso, Luigi Orsina, Giuseppe La Torre, Francesca Romana Ripani
BACKGROUND: Although standard instrumentation is the procedure most frequently used to implant a total knee arthroplasty (TKA), high rates of malalignment of tibial component are reported using this technique. Anatomical landmarks for sagittal alignment have been little investigated and the best reference axis which parallels the mechanical axis is yet to be established. HYPOTHESIS: Mapping the anterior tibial profile (ATP) may allow the identification of segmental zones of the ATP parallel to the mechanical axis which can be use to align the extramedullary rod...
June 20, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28644188/surgical-techniques-for-total-knee-arthroplasty-measured-resection-gap-balancing-and-hybrid
#3
Neil P Sheth, Adeel Husain, Charles Lenwood Nelson
Total knee arthroplasty (TKA) is effective in managing end-stage degenerative joint disease. Achieving favorable clinical outcomes is predicated on proper implant alignment, sizing, and rotation as well as adequate soft-tissue balancing. Modern TKA implants are designed to address the fundamental needs of attaining stability in both flexion and extension and of optimizing patellar tracking. Measured resection and gap balancing are the two different techniques used to implant the TKA components used today. Both techniques have been validated as durable and successful, and each has unique advantages and disadvantages...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28641973/changes-in-hip-knee-and-ankle-coronal-alignments-after-total-hip-arthroplasty-with-transverse-femoral-shortening-osteotomy-for-unilateral-crowe-type-iv-developmental-dysplasia-of-the-hip
#4
Abdulhamit Misir, Turan B Kizkapan, Kadir I Yildiz, Mehmet A Kaygusuz, Yakup Alpay, Atakan Ezici
BACKGROUND: To investigate changes in lower extremity coronal alignment in patients with unilateral Crowe type IV developmental dysplasia of the hip who underwent total hip arthroplasty with transverse femoral shortening osteotomy. METHODS: We reviewed the preoperative and 1-year postoperative full-length lower extremity radiographs of 25 patients. Femoral offset (FO), mechanical hip-knee-ankle angle, anatomical axis, mechanical axis deviation (MAD), mechanical lateral proximal femoral angle, anatomical medial proximal femoral angle, mechanical lateral distal femoral angle, anatomical lateral distal femoral angle, knee joint line congruency angle, mechanical medial proximal tibial angle, mechanical lateral distal tibial angle, ankle joint line orientation angle, tibial plafond talus angle, extremity length, and pelvic obliquity were measured on both the operative and nonoperative sides...
June 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28640896/beneficial-effects-of-a-gait-used-while-wearing-a-kimono-to-decrease-the-knee-adduction-moment-in-healthy-adults
#5
Susumu Ota, Yukari Ogawa, Hiroki Ota, Tomoya Fujiwara, Tadashi Sugiyama, Akira Ochi
The knee adduction moment (KAM) relates to medial knee osteoarthritis (OA). Several gait modifications to reduce the KAM for the prevention of knee OA have been studied. Most of the modifications, however, involve voluntary changes in leg alignment. Here we investigated the biomechanical effects for reducing the KAM of a walking style with a small trunk rotation and arm swing gait, which is a natural walking style used while wearing a kimono (Nanba walk) that shifts the ground reaction force toward the stance leg (reduced lever arm)...
2017: PloS One
https://www.readbyqxmd.com/read/28638492/importance-of-radiological-evaluation-of-global-spinal-balance-together-with-lower-limb-alignment-in-planning-lumbar-spine-deformity-surgery-illustrative-case-presentation
#6
Mariusz Głowacki, Jerzy Walecki, Przemysław Kołakowski, Danuta Kolońska
BACKGROUND: The presented case illustrates the critical role of a detailed preoperative radiological evaluation in complex spine surgery. CASE REPORT: A 49-year-old patient was admitted for a revision surgery after L3-L5 fusion. Preoperative assessment showed preserved sagittal balance, coronal imbalance and valgus knee deformity. The patient reported pain of 8-10 in VAS (Visual Analogue Scale) and had an ODI (Oswestry Disability Index) of 60%. The first step of the surgery was L2-S1 fusion with decompression and spine deformity correction...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28638170/atlas-based-automatic-measurements-of-the-morphology-of-the-tibiofemoral-joint
#7
M Brehler, G Thawait, W Shyr, J Ramsay, J H Siewerdsen, W Zbijewski
PURPOSE: Anatomical metrics of the tibiofemoral joint support assessment of joint stability and surgical planning. We propose an automated, atlas-based algorithm to streamline the measurements in 3D images of the joint and reduce user-dependence of the metrics arising from manual identification of the anatomical landmarks. METHODS: The method is initialized with coarse registrations of a set of atlas images to the fixed input image. The initial registrations are then refined separately for the tibia and femur and the best matching atlas is selected...
February 11, 2017: Proceedings of SPIE
https://www.readbyqxmd.com/read/28637433/postoperative-alignment-of-tka-in-patients-with-severe-preoperative-varus-or-valgus-deformity-is-there-a-difference-between-surgical-techniques
#8
Stefan Rahm, Roland S Camenzind, Andreas Hingsammer, Christopher Lenz, David E Bauer, Mazda Farshad, Sandro F Fucentese
BACKGROUND: There have been conflicting studies published regarding the ability of various total knee arthroplasty (TKA) techniques to correct preoperative deformity. The purpose of this study was to compare the postoperative radiographic alignment in patients with severe preoperative coronal deformity (≥10° varus/valgus) who underwent three different TKA techniques; manual instrumentation (MAN), computer navigated instrumentation (NAV) and patient specific instrumentation (PSI). METHODS: Patients, who received a TKA with a preoperative coronal deformity of ≥10° with available radiographs were included in this retrospective study...
June 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28634785/-imaging-and-preoperative-planning-for-osteotomies-around-the-knee
#9
REVIEW
D Pape, A Hoffmann, R Seil
Physiologic alignment of the human lower leg is well defined. The etiology for malalignment comprises constitutional, degenerative and posttraumatic conditions. Osteotomies around the knee can correct the malalignment, provided that the origin of deviation is in proximity of the knee center. Crucial factors for the evaluation of axis deviation are the weight-bearing line, the mechanical axes of femur and tibia, the joint line angles and the center of the hip, knee and upper ankle joint. Careful preoperative planning is mandatory for reproducible clinical results...
June 20, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28633973/patellofemoral-osteoarthritis-progression-and-alignment-changes-after-open-wedge-high-tibial-osteotomy-do-not-affect-clinical-outcomes-at-mid-term-follow-up
#10
Kenichi Goshima, Takeshi Sawaguchi, Kenji Shigemoto, Shintaro Iwai, Akira Nakanishi, Ken Ueoka
PURPOSE: To evaluate the clinical and radiological outcomes of open-wedge high tibial osteotomy (OWHTO) with respect to the patellofemoral joint and to assess whether patellofemoral osteoarthritis (OA) progression and alignment changes after OWHTO affect clinical outcomes. METHODS: Inclusion criteria were consecutive patients who underwent OWHTO from March 2005 to September 2013. Exclusion criteria were loss to follow-up within 2 years and absence of second-look arthroscopy findings at the time of plate removal...
June 17, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28632776/dynamic-knee-valgus-alignment-influences-impact-attenuation-in-the-lower-extremity-during-the-deceleration-phase-of-a-single-leg-landing
#11
Akihiro Tamura, Kiyokazu Akasaka, Takahiro Otsudo, Jyunya Shiozawa, Yuka Toda, Kaori Yamada
Dynamic knee valgus during landings is associated with an increased risk of non-contact anterior cruciate ligament (ACL) injury. In addition, the impact on the body during landings must be attenuated in the lower extremity joints. The purpose of this study was to investigate landing biomechanics during landing with dynamic knee valgus by measuring the vertical ground reaction force (vGRF) and angular impulses in the lower extremity during a single-leg landing. The study included 34 female college students, who performed the single-leg drop vertical jump...
2017: PloS One
https://www.readbyqxmd.com/read/28632587/the-clinical-outcome-of-computer-navigated-compared-with-conventional-knee-arthroplasty-in-the-same-patients-a-prospective-randomized-double-blind-long-term-study
#12
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
BACKGROUND: The available comparative studies of computer navigation-assisted and conventional knee arthroplasties have short-term follow-up periods. Therefore, the clinical benefits after long-term follow-up are not clear. The purposes of the current long-term study were to compare clinical outcomes, alignment of the knee components, prevalence of aseptic loosening of the components, implant survival, and complications of total knee arthroplasties performed with and without computer navigation...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28630758/optimising-position-and-stability-in-total-knee-arthroplasty
#13
Jan Victor
Alignment and stability are two key factors for success in total knee arthroplasty (TKA). Several techniques have been advocated, the two best known being measured resection and tensioned gaps.Dogma and fuzzy wording have cast an obscure shadow on the dualistic discussion between proponents of both techniques.This review is an attempt to clarify definitions, analyse the flaws and pitfalls in the different techniques and make some suggestions for improvement. Cite this article: EFORT Open Rev 2017;2. DOI: 10...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28624759/gps-attitudes-beliefs-and-behaviours-regarding-exercise-for-chronic-knee-pain-a-questionnaire-survey
#14
Elizabeth Cottrell, Nadine E Foster, Mark Porcheret, Trishna Rathod, Edward Roddy
OBJECTIVES: The aim of this study was to investigate general practitioners' (GPs) attitudes, beliefs and behaviours regarding the use of exercise for patients with chronic knee pain (CKP) attributable to osteoarthritis. SETTING: Primary care GPs in the UK. PARTICIPANTS: 5000 GPs, randomly selected from Binley's database, were mailed a cross-sectional questionnaire survey. OUTCOME MEASURES: GPs' attitudes and beliefs were investigated using attitude statements, and reported behaviours were identified using vignette-based questions...
June 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28615059/analysis-of-factors-that-affect-the-precision-of-the-radiographic-lateral-femoral-bowing-angle-using-a-three-dimensional-computed-tomography-based-modelling-technique
#15
Ye-Ran Li, Yu-Hang Gao, Xin Qi, Jian-Guo Liu, Lu Ding, Chen Yang, Zheng Zhang, Shu-Qiang Li
BACKGROUND: Precise measurement of lateral femoral bowing is important to achieve postoperative lower limb alignment. We aimed to investigate factors that affect the precision of the radiographic lateral femoral bowing (RLFB) angle using three-dimensional (3D) models and whether the angle affects surgery design. METHODS: Forty femurs in total were divided into two groups based on their preoperative RLFB angle. The flexion contracture angle, preoperative and postoperative RLFB angles, and intersection angle between the mechanical and anatomical axes were compared...
June 14, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28614288/evaluation-of-the-tibial-tubercle-to-posterior-cruciate-ligament-distance-in-a-pediatric-patient-population
#16
Blake Clifton, Dustin L Richter, Dan Tandberg, Matthew Ferguson, Gehron Treme
BACKGROUND: Evaluation of distal extensor mechanism alignment continues to evolve in children with patella instability. Prior studies support the use of the tibial tubercle to trochlear groove (TT-TG) distance but limitations exist for this measurement including: changes in the TT-TG distance with knee flexion, difficulty with finding the deepest part of a dysplastic trochlea, and limitations regarding identification of the site of the anatomic abnormality. The tibial tubercle-posterior cruciate ligament (TT-PCL) distance has been introduced as an alternative measure to address the shortcomings in the TT-TG distance by quantifying the position of the TT independent of the trochlea and with respect to the tibia only...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28607784/use-of-nonvascularized-autologous-fibular-strut-graft-in-the-treatment-of-major-bone-defect-after-periprosthetic-knee-fracture
#17
Vincenzo Giordano, Bruno Parilha Coutinho, Mateus Kenji Miyahira, Felipe Serrão Mendes de Souza, Ney Pecegueiro do Amaral
We present the case of a patient who suffered a comminuted supracondylar periprosthetic femur fracture. The patient was an 86-year-old lady who suffered a minor fall at home and presented at our hospital with a right comminuted distal femur fracture around a total knee arthroplasty. The patient was submitted to a cruciate-sacrificing total knee replacement 6 years before at the same institution. Despite severe metaphyseal fragmentation and short distal fragment, the prosthesis was stable; thus, open fracture reduction and stabilization with internal fixation were performed...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28606122/anterior-tibial-curved-cortex-is-a-reliable-landmark-for-tibial-rotational-alignment-in-total-knee-arthroplasty
#18
Joong Il Kim, Jak Jang, Ki Woong Lee, Hyuk Soo Han, Sahnghoon Lee, Myung Chul Lee
BACKGROUND: Rotational alignment of the tibial component is important for long-term success of total knee arthroplasty (TKA). This study aimed to compare five axes in normal and osteoarthritic (OA) knees to determine a reliable landmark for tibial rotational alignment in TKA. METHODS: One hundred twenty patients with OA knees and 40 with normal knees were included. The angle between a line perpendicular to the surgical transepicondylar axis and each of five axes were measured on preoperative computed tomography...
June 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28600996/lower-limb-alignment-and-laxity-measures-before-during-and-after-total-knee-arthroplasty-a-prospective-cohort-study
#19
Jon V Clarke, Angela H Deakin, Frederic Picard, Philip E Riches
BACKGROUND: This study compared knee alignment and laxity in patients before, during and after total knee arthroplasty, using methodologically similar procedures, with an aim to help inform pre-operative planning. METHODS: Eighteen male and 13 female patients were recruited, mean age 66years (51-82) and mean body mass index of 33 (23-43). All were assessed pre- and postoperatively using a non-invasive infrared position capture system and all underwent total knee arthroplasty using a navigation system...
May 26, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28599554/regular-chondrocyte-spacing-is-a-potential-cause-for-coherent-ultrasound-backscatter-in-human-articular-cartilage
#20
Daniel Rohrbach, Satu I Inkinen, Jana Zatloukalová, Anke Kadow-Romacker, Antti Joukainen, Markus K Malo, Jonathan Mamou, Juha Töyräs, Kay Raum
The potential of quantitative ultrasound (QUS) to assess the regular cellular spacing in the superficial cartilage zones was investigated experimentally and numerically. Nine osteochondral samples, extracted from two human cadaver knee joints, were measured using a 50-MHz ultrasound scanning device and evaluated using Mankin score. Simulated backscattered power spectra from models with an idealized cell alignment exhibited a pronounced frequency peak. From the peak, cell spacing in the range between 15 and 40 μm between cell layers was detected with an average error of 0...
May 2017: Journal of the Acoustical Society of America
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