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https://www.readbyqxmd.com/read/29444542/kinematically-aligned-total-knee-arthroplasty-or-mechanically-aligned-total-knee-arthroplasty
#1
Tsuneari Takahashi, Juned Ansari, Hemant G Pandit
Kinematically aligned total knee arthroplasty (KATKA) was developed to more anatomically align the knee prosthesis to restore the native alignment of the knee and promote physiological kinematics. Even though there are concerns with implant survival, and follow-up at 10 years or more after KATKA has not been reported, there is a negligible incidence of failure of a tibial component at 2 to 9 years. Early clinical results with this technique are encouraging and demonstrate better functional outcomes compared with mechanically aligned TKA (MATKA)...
February 14, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29443848/corr-insights%C3%A2-polyethylene-damage-increases-with-varus-implant-alignment-in-posterior-stabilized-and-constrained-condylar-knee-arthroplasty
#2
Matthew B Collier
No abstract text is available yet for this article.
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29443845/raising-the-joint-line-in-tka-is-associated-with-mid-flexion-laxity-a-study-in-cadaver-knees
#3
Thomas Luyckx, Hilde Vandenneucker, Lennart Scheys Ing, Evie Vereecke, Arnout Victor Ing, Jan Victor
BACKGROUND: In a typical osteoarthritic knee with varus deformity, distal femoral resection based off the worn medial femoral condyle may result in an elevated joint line. In a setting of fixed flexion contracture, the surgeon may choose to resect additional distal femur to obtain extension, thus purposefully raising the joint line. However, the biomechanical effect of raising the joint line is not well recognized. QUESTIONS/PURPOSES: (1) What is the effect of the level of the medial joint line (restored versus raised) on coronal plane stability of a TKA? (2) Does coronal alignment technique (mechanical axis versus kinematic technique) affect coronal plane stability of the knee? (3) Can the effect of medial joint-line elevation on coronal plane laxity be predicted by an analytical model? METHODS: A TKA prosthesis was implanted in 10 fresh frozen nonarthritic cadaveric knees with restoration of the medial joint line at its original level (TKA0)...
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29439922/increased-precision-of-coronal-plane-outcomes-in-robotic-assisted-total-knee-arthroplasty-a%C3%A2-systematic-review-and-meta-analysis
#4
REVIEW
Ashim Mannan, James Vun, Christopher Lodge, Alistair Eyre-Brook, Simon Jones
BACKGROUND: Inaccuracy of component alignment in total knee arthroplasty adversely impacts outcomes. Robotic systems improve translation of pre-operative planning to intra-operative steps, theoretically resulting in greater accuracy and precision. In this study we systematically review literature data of alignment outcomes and apply meta-analysis methods to assess whether robotic-assisted knee arthroplasty provides superior outcomes when compared to conventional knee prostheses. METHODS: A PRISMA compliant search comparing alignment outcomes in robotic vs conventional knee arthroplasty was performed...
February 10, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29433583/mid-term-survivorship-of-cruciate-retaining-versus-posterior-stabilized-total-knee-arthroplasty-using-modular-mini-keel-tibial-implants
#5
Cheng-Pang Yang, Kuo-Yao Hsu, Yu-Han Chang, Yi-Sheng Chan, Hsin-Nung Shih, Alvin Chao-Yu Chen
BACKGROUND: Reports of diverse outcomes in modular mini-keel tibial componentry for total knee arthroplasty (TKA) have raised concerns about early aseptic loosening. Cruciate-retaining (CR) prostheses, using mini-keel implants, have yet to be reported and compared to posterior-stabilizing (PS) designs. METHODS: A retrospective, case-matched study of 91 consecutive TKAs (n = 46 CR; n = 45 PS prostheses), using modular mini-keel tibial componentry with a 45-mm drop down stem extension, was conducted...
February 13, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29431306/knee-alignment-and-its-significance-is-it-really-different-in-various-population-groups
#6
EDITORIAL
Eyal Ginesin, Doron Norman, Bezalel Peskin
No abstract text is available yet for this article.
February 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29431299/clinical-knee-alignment-among-adolescents-and-association-with-body-mass-index-a-large-prevalence-study
#7
Noam Shohat, Yossy Machluf, Rivka Farkash, Aharon S Finestone, Yoram Chaiter
BACKGROUND: Children and adolescents are commonly referred to an orthopedic surgeon to assess knee malalignment. OBJECTIVES: To assess the prevalence of genu varum and valgum among adolescents, and to identify correlates of these conditions. METHODS: A medical database of 47,588 candidates for military service presenting to the northern recruitment center during an 11 year period was analyzed to identify clinical knee alignment. Based on the standing skin surface intercondylar distance (ICD) or intermalleolar distance (IMD), the prevalence rates of genu varum (ICD ≥ 3 cm) and genu valgum (IMD ≥ 4 cm) were calculated...
February 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29428984/tibial-component-coverage-and-rotational-alignment-accuracy-after-mobile-bearing-total-knee-arthroplasty
#8
Yoshinori Ishii, Hideo Noguchi, Junko Sato, Hana Ishii, Koji Todoroki, Shin-Ichi Toyabe
BACKGROUND: Tibial component coverage (TCC) and tibial rotational angle (TRA) have been studied simultaneously in simulations, but not in clinical studies after total knee arthroplasty (TKA). The purposes of this study were (1) to evaluate TCC and rotational setting postoperatively in mobile-bearing TKA patients and (2) to compare the results with previously published simulation data. METHODS: We prospectively examined 100 patients who underwent primary TKA using the LCS® Total Knee System (LCS) posterior cruciate ligament-substituting prosthesis...
February 10, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29427751/a-novel-technique-for-estimating-component-sizes-in-total-knee-arthroplasty
#9
Haroon Rehman, David R W MacDonald, Matthew Smith, Syaza Zainudin, Graham Robertson, Martin Mitchell
INTRODUCTION: Intra-operative assessment of total knee arthroplasty (TKA) components is performed with manufacturer specific jigs. Pre-operative templating, patient specific knee cutting blocks and computer-assisted surgeries have also been used to improve alignment and sizing; although the literature shows marginal improvement in functional scores. We propose pre-operative shoe size as a simple measurement tool for estimating the component sizes required for TKA. We investigate the relationship between TKA implant sizes, height, body weight and shoe size...
February 7, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29427725/knee-extensor-strength-gains-mediate-symptom-improvement-in-knee-osteoarthritis-secondary-analysis-of-a-randomised-controlled-trial
#10
Michelle Hall, Rana S Hinman, Tim V Wrigley, Jessica Kasza, Boon-Whatt Lim, Kim L Bennell
OBJECTIVE: To determine if an increase in knee extensor strength mediates the effect of a 12-week knee extensor strength training program on pain and physical function improvement in people with knee osteoarthritis. DESIGN: Secondary analysis from a randomised controlled trial comparing the effects of a 12-week knee extensor strengthening exercise program to a control group with no intervention. METHODS: Data from participants with complete data (n=97) enrolled in a previous clinical trial were analysed...
February 7, 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29424452/evidence-and-mechanism-by-which-upper-partial-fibulectomy-improves-knee-biomechanics-and-decreases-knee-pain-of-osteoarthritis
#11
Yong Nie, ZeYu Huang, Bin Xu, Bin Shen, Virginia Byers Kraus, FuXing Pei
To investigate the change in short-term clinical outcomes and biomechanical properties of the knee in response to upper partial fibulectomy and to probe into the biomechanical mechanism underlying the clinical benefits of upper partial fibulectomy for medial compartment knee osteoarthritis (KOA). 29 patients with medial compartment KOA underwent upper partial fibulectomy. Visual analog scale (VAS) pain, the hospital for special surgery knee score (HSS), hip-knee-ankle (HKA) angle (measured in the frontal plane), and flexion/extension range of motion of the knee were assessed before and up to 6 months after surgery...
February 9, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29417324/radiological-severity-of-hip-osteoarthritis-in-patients-with-adult-spinal-deformity-the-effect-on-spinopelvic-and-lower-extremity-compensatory-mechanisms
#12
Louis M Day, Edward M DelSole, Bryan M Beaubrun, Peter L Zhou, John Y Moon, Jared C Tishelman, Jonathan M Vigdorchik, Ran Schwarzkopf, Renaud Lafage, Virginie Lafage, Themistocles Protopsaltis, Aaron J Buckland
PURPOSE: Sagittal spinal deformity (SSD) patients utilize pelvic tilt (PT) and their lower extremities in order to compensate for malalignment. This study examines the effect of hip osteoarthritis (OA) on compensatory mechanisms in SSD patients. METHODS: Patients ≥ 18 years with SSD were included for analysis. Spinopelvic, lower extremity, and cervical alignment were assessed on standing full-body stereoradiographs. Hip OA severity was graded by Kellgren-Lawrence scale (0-4)...
February 7, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29413195/editorial-commentary-knee-medial-meniscus-root-tears-you-may-not-have-seen-it-but-it-s-seen-you
#13
EDITORIAL
Aaron J Krych
Medial meniscus root tears are becoming increasingly recognized in clinical practice as a source of profound pain and dysfunction in patients. There has been considerable debate about the cause of these distinct meniscus tears, and what the optimal treatment should be for an individual patient. Midterm medial meniscus root repair results suggest that in a well-aligned knee with minimal degenerative change, transtibial root repair is an effective technique for improving pain, function, and possibly preventing further cartilage degeneration...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29401510/physiological-joint-line-total-knee-arthroplasty-designs-are-especially-sensitive-to-rotational-placement-a-finite-element-analysis
#14
Philippe Moewis, Sara Checa, Ines Kutzner, Hagen Hommel, Georg N Duda
Mechanical and kinematical aligning techniques are the usual positioning methods during total knee arthroplasty. However, alteration of the physiological joint line and unbalanced medio-lateral load distribution are considered disadvantages in the mechanical and kinematical techniques, respectively. The aim of this study was to analyse the influence of the joint line on the strain and stress distributions in an implanted knee and their sensitivity to rotational mal-alignment. Finite element calculations were conducted to analyse the stresses in the PE-Inlay and the mechanical strains at the bone side of the tibia component-tibia bone interface during normal positioning of the components and internal and external mal-rotation of the tibial component...
2018: PloS One
https://www.readbyqxmd.com/read/29398995/preoperative-valgus-alignment-does-not-predict-inferior-outcome-of-total-knee-arthroplasty
#15
Cynthia A Kahlenberg, Myra Trivellas, Yuo-Yu Lee, Douglas E Padgett
Background: Preoperative valgus deformity is present in an estimated 10-20% of patients undergoing total knee replacement (TKR). Questions/Purposes: The objective of this study was to compare the Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores after TKR in a matched cohort of patients with preoperative valgus and varus deformities. Methods: This is a matched cohort study of 162 patients with varus native knees and 162 patients with valgus native knees who underwent TKR and were prospectively followed in our institutional registry...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/29397412/resection-arthrodesis-using-distraction-osteogenesis-then-plating-as-a-hybrid-surgical-technique-for-the-management-of-bone-sarcomas-of-the-distal-tibia
#16
Teng-Fei Lou, Hua Li, Yi-Min Chai, Chun-Yang Wang, Sheng-He Liu, Musha Hamushan, Fan Wu, Wei-Jie Cai, Pei Han
PURPOSE: We report the oncological and functional results of limb salvage for bone sarcomas involving the distal tibia using hybrid surgical technique of resection arthrodesis by bone transport then plating. METHODS: Five patients (mean age 18.6 years) with primary distal tibial sarcomas (two Ewing's sarcomas and three osteosarcomas) were treated by this method. The average duration of follow-up is 53 months. All patients accepted distraction osteogenesis with a standard technique using external fixator after wide (four cases) or marginal (one case) resection in the first operation...
February 3, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29395747/a-preliminary-modeling-investigation-into-the-safe-correction-zone-for-high-tibial-osteotomy
#17
Jennifer Lb Martay, Antony Jr Palmer, Neil K Bangerter, Stuart Clare, A Paul Monk, Cameron P Brown, Andrew J Price
BACKGROUND: High tibial osteotomy (HTO) re-aligns the weight-bearing axis (WBA) of the lower limb. The surgery reduces medial load (reducing pain and slowing progression of cartilage damage) while avoiding overloading the lateral compartment. The optimal correction has not been established. This study investigated how different WBA re-alignments affected load distribution in the knee, to consider the optimal post-surgery re-alignment. METHODS: We collected motion analysis and seven Tesla MRI data from three healthy subjects, and combined this data to create sets of subject-specific finite element models (total=45 models)...
January 21, 2018: Knee
https://www.readbyqxmd.com/read/29395720/distal-femoral-rotation-correlates-with-proximal-tibial-joint-line-obliquity-a-consideration-for-kinematic-total-knee-arthroplasty
#18
Chung Kia Ng, Jerry Yongqiang Chen, Jared Ze Yang Yeh, Jade Pei Yuik Ho, Azhar M Merican, Seng Jin Yeo
BACKGROUND: We hypothesized that there is a correlation between the distal femoral rotation and proximal tibial joint line obliquity in nonarthritic knees. This has significance for kinematic knee arthroplasty, in which the target knee alignment desired approximates the knee before disease. METHODS: Fifty computed tomography scans of nonarthritic knees were evaluated using three-dimensional image processing software. Four distal femoral rotational axes were determined in the axial plane: the transepicondylar axis (TEA), transcondylar axis (TCA), posterior condylar axis (PCA), and a line perpendicular to Whiteside's anterior-posterior axis...
December 28, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29389790/femoral-component-varus-malposition-is-associated-with-tibial-aseptic-loosening-after-tka
#19
Bum-Sik Lee, Hyun-Ik Cho, Seong-Il Bin, Jong-Min Kim, Byeong-Kyu Jo
BACKGROUND: The notion that neutral alignment is mandatory to assure long-term durability after TKA has been based mostly on short-film studies. However, this is challenged by recent long-film studies. QUESTIONS/PURPOSES: We conducted this long-film study to know (1) whether the risk of aseptic revision for nontraumatic reasons was greater among knees with greater than 3° varus or valgus (defined as "outliers") than those that were aligned within 3° of neutral on long-standing mechanical axis (hip to knee) radiographs; and (2) what the failure mechanisms were and whether the malalignment was femoral or tibial in origin, or both, among those in the outlier group...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29389753/2017-chitranjan-s-ranawat-award-does-computer-navigation-in-knee-arthroplasty-improve-functional-outcomes-in-young-patients-a-randomized-study
#20
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
BACKGROUND: Proponents of computer-assisted TKA suggest that better alignment of the TKAs will lead to improved long-term patient functional outcome and survivorship of the implants. However, there is little evidence about whether the improved position and alignment of the knee components obtained using computer navigation improve patient function and the longevity of the TKA. QUESTIONS/PURPOSES: The purpose of this study was to determine whether (1) clinical results; (2) radiographic and CT scan results; and (3) the survival rate of TKA components would be better in patients having computer-assisted TKA than results of patients having TKA without computer-assisted TKA...
January 2018: Clinical Orthopaedics and related Research
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