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https://www.readbyqxmd.com/read/28210787/articular-surface-mounted-navigated-total-knee-arthroplasty-improves-the-reliability-of-component-alignment
#1
N D Clement, D MacDonald, A G Burgess, C R Howie
PURPOSE: The primary aim was to compare the early knee-specific functional outcome after articular surface mounted (ASM) navigation with non-navigated TKA. The secondary aims were to compare general physical and mental health improvement, patient satisfaction, and reliability of component alignment in the sagittal and coronal planes between ASM navigated TKA with that of non-navigated TKA. METHODS: Prospective functional outcome and radiographic data were collect for 123 patients undergoing ASM navigation and 172 patients undergoing non-navigated TKA by a high volume single surgeon...
February 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28210786/females-younger-patients-and-patients-with-high-bmi-have-the-highest-pre-operative-knee-awareness-measured-using-the-forgotten-joint-score
#2
Dana Li, A Troelsen, L Ingelsrud, H Husted, K Gromov
PURPOSE: The Forgotten Joint Score (FJS) is a novel measurement for patients' awareness of their knee in daily life. By identifying factors that could explain pre-operative FJS levels, the clinician could better prioritize and single out patients who would benefit most from TKA. The aim of this study was to identify possible factors that may explain the variance of pre-operative FJS levels and evaluate the relationship between pre-operative FJS and pre-operative Oxford Knee Score (OKS)...
February 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28209345/multiobjective-optimization-of-cartilage-stress-for-non-invasive-patient-specific-recommendations-of-high-tibial-osteotomy-correction-angle-a-novel-method-to-investigate-alignment-correction
#3
Keke Zheng, Corey J Scholes, Junning Chen, David Parker, Qing Li
Medial opening wedge high tibial osteotomy (MOWHTO) is a surgical procedure to treat knee osteoarthritis associated with varus deformity. However, the ideal final alignment of the Hip-Knee-Ankle (HKA) angle in the frontal plane, that maximizes procedural success and post-operative knee function, remains controversial. Therefore, the purpose of this study was to introduce a subject-specific modeling procedure in determining the biomechanical effects of MOWHTO alignment on tibiofemoral cartilage stress distribution...
February 13, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28209278/the-impact-of-coronal-plane-alignment-on-polyethylene-wear-and-damage-in-total-knee-arthroplasty-a-retrieval-study
#4
Pieter-Jan T K Vandekerckhove, Matthew G Teeter, Douglas D R Naudie, James L Howard, Steven J MacDonald, Brent A Lanting
BACKGROUND: Coronal plane alignment is one of the contributing factors to polyethylene wear in total knee arthroplasty. METHODS: Based on 95 retrieved polyethylene inserts, wear and damage patterns were analyzed in relationship to the overall mechanical alignment and to the position of the tibial component. RESULTS: A progression of wear was observed with progressively mechanical varus alignment. However, there was significantly more damage in the lateral compartment in the mild and moderate varus group compared to the valgus group...
January 4, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28202207/catastrophic-varus-collapse-of-the-tibia-in-obese-total-knee-arthroplasty
#5
Thomas K Fehring, Keith A Fehring, Lucas A Anderson, Jesse E Otero, Bryan D Springer
BACKGROUND: Mechanical complications have been underemphasized in reports on total knee arthroplasty (TKA) in obese patients. Noticing an increased prevalence of varus collapse of the tibia in obese total knee patients, we sought to determine if variability in proximal tibial cancellous bone strength played a role in failure. We attempted to define a cancellous threshold above which alternative methods of fixation should be used. METHODS: One thousand one hundred six revision TKAs from 2004-2014 identified 35 patients with varus collapse of the tibia, defined as a change in component position of >10°...
January 30, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28194499/bone-femoral-component-interface-gap-after-sagittal-mechanical-axis-alignment-is-filled-with-new-bone-after-cementless-total-knee-arthroplasty
#6
Shinichi Kuriyama, Katsufumi Hyakuna, Satoshi Inoue, Yasutsugu Kawai, Yasuyuki Tamaki, Hiromu Ito, Shuichi Matsuda
PURPOSE: This study retrospectively evaluated the fate of mismatch between an uncemented femoral component and each femoral cut surface (i.e., wedge-shaped gap) relative to sagittal mechanical alignment in total knee arthroplasty (TKA). METHODS: Primary TKA was performed on 99 consecutive knees. The femoral components were aligned to the sagittal mechanical axis with CT-based navigation. All patients were assessed with postoperative true lateral radiographs. Bone-side surfaces of the uncemented femoral component were divided into five zones: anterior flange, anterior chamfer, posterior chamfer, posterior part, and distal part, which were defined as zones 1 to 5, respectively...
February 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28192825/dynamic-alignment-analysis-in-the-osteoarthritic-knee-using-computer-navigation
#7
Ricardo Larrainzar-Garijo, David Murillo-Vizuete, Raul Garcia-Bogalo, David Escobar-Anton, Lissette Horna-Castiñeiras, Juan Vicente Peralta-Molero
The lower limb alignment is influenced by the geometry of the joint surfaces and surrounding soft tissue tension. The mechanical behavior changes in a normal, osteoarthritic, and postoperative knee. The purpose of this study is to determine the dynamic coronal femoral tibial mechanical angle (FTMA) in osteoarthritic knees using computer navigation. The authors hypothesize that there are different varus-valgus patterns between flexion and extension in the osteoarthritic knee. We conducted a transversal observational study and included patients with osteoarthritis who underwent primary navigation TKA (Orthopilot version 4...
February 13, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28185777/survivorship-and-patient-satisfaction-of-robotic-assisted-medial-unicompartmental-knee-arthroplasty-at-a-minimum-two-year-follow-up
#8
Andrew D Pearle, Jelle P van der List, Lily Lee, Thomas M Coon, Todd A Borus, Martin W Roche
BACKGROUND: Successful clinical outcomes following unicompartmental knee arthroplasty (UKA) depend on lower limb alignment, soft tissue balance and component positioning, which can be difficult to control using manual instrumentation. Although robotic-assisted surgery more reliably controls these surgical factors, studies assessing outcomes of robotic-assisted UKA are lacking. Therefore, a prospective multicenter study was performed to assess outcomes of robotic-assisted UKA. METHODS: A total of 1007 consecutive patients (1135 knees) underwent robotic-assisted medial UKA surgery from six surgeons at separate institutions between March 2009 and December 2011...
February 6, 2017: Knee
https://www.readbyqxmd.com/read/28185754/does-residual-varus-alignment-cause-increasing-varus-laxity-at-a-minimum-of-five-years-after-total-knee-arthroplasty
#9
Kazuhisa Hatayama, Masanori Terauchi, Kenichi Saito, Hiroshi Higuchi
BACKGROUND: The purpose of this study is to investigate whether varus-valgus laxity of cruciate-retaining (CR) total knee arthroplasty (TKA) changes between 1 year and >5 years after surgery based on postoperative limb alignment. METHODS: One hundred twenty-one varus osteoarthritic knees that underwent CR TKA were included. The minimum follow-up was 5 years. Weight-bearing full-leg radiographs were obtained postoperatively and the hip-knee-ankle (HKA) angle was measured...
January 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28181833/influence-of-a-full-body-compression-suit-on-trunk-positioning-and-knee-joint-mechanics-during-lateral-movements
#10
Guillaume Mornieux, Elmar Weltin, Monika Pauls, Franz Rott, Albert Gollhofer
Trunk positioning has been shown to be associated with knee joint loading during athletic tasks, especially changes of direction. The purpose of the present study was to test whether a full body compression suit (FBCS) would improve trunk positioning and knee joint control during lateral movements. Twelve female athletes performed lateral reactive jumps (LRJ) and unanticipated cuttings with and without the customized FBCS, while 3D kinematics and kinetics were measured. FBCS did not influence trunk positioning during LRJ and led to increased trunk lateral lean during cuttings (P < ...
February 9, 2017: Journal of Applied Biomechanics
https://www.readbyqxmd.com/read/28173989/analysis-of-the-factors-that-correlate-with-increased-knee-adduction-moment-during-gait-in-the-early-postoperative-period-following-total-knee-arthroplasty
#11
Takeo Nagura, Yasuo Niki, Kengo Harato, Takeshi Mochizuki, Yoshimori Kiriyama
BACKGROUND: Analysis of dynamic knee loading during gait is essential to prevent mechanical failures following total knee arthroplasty. External knee adduction moment during gait is the primary factor producing medial joint reaction force, and an increase in the moment is directly related to an increase in the medial compartment load on the knee. METHODS: Knee adduction moment during gait in 39 knees of 32 female patients following a posterior stabilized knee replacement with a single surgeon was evaluated at 1...
February 4, 2017: Knee
https://www.readbyqxmd.com/read/28167879/early-revision-surgery-for-tibial-plateau-non-union-and-mal-union
#12
Dominic L Van Nielen, Christopher S Smith, David L Helfet, Peter Kloen
BACKGROUND: Although relatively rare, non-unions and mal-unions of tibial plateau fractures present significant challenges for the orthopedic surgeon. With careful pre-operative planning, tibial plateau mal-union or non-union revision surgery with intra-articular and varus opening osteotomies can provides good functional results when performed early (within 1 year) after primary surgical procedure. QUESTIONS/PURPOSES: We present our treatment algorithm for approaching and treating non-union or mal-union of tibial plateau fractures...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28166705/high-tibial-osteotomy-combined-with-cancellous-bone-graft-and-osteochondral-autograft-transplantation-in-a-patient-with-massive-osteochondral-defects-in-the-medial-femoral-condyle
#13
Takehiko Matsushita, Shu Watanabe, Daisuke Araki, Tomoyuki Matsumoto, Koji Takayama, Masahiro Kurosaka, Ryosuke Kuroda
Treatment of massive osteochondral defects of the medial femoral condyle is challenging. A 46-year-old man who had a medial femoral condyle fracture on his left knee underwent osteosynthesis in a hospital, but the pain remained and the patient was referred to our hospital 8 months after the surgery. Radiographs showed a varus alignment of the leg, and magnetic resonance image showed a massive necrotic area in the medial femoral condyle. The patient received high tibial osteotomy (HTO) combined with iliac cancellous bone graft and an osteochondral autograft transplantation...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28165760/comparison-of-acl-strain-in-the-mcl-deficient-and-mcl-reconstructed-knee-during-simulated-landing-in-a-cadaveric-model
#14
Eric J Mancini, Robert Kohen, Amanda O Esquivel, Allison M Cracchiolo, Stephen Edward Lemos
BACKGROUND: Noncontact anterior cruciate ligament (ACL) injury after valgus landing has been reported and studied biomechanically. However, the role of the medial collateral ligament (MCL) in dissipating these forces has not been fully elucidated. Purpose/Hypothesis: The purpose of this study was to investigate the role that the MCL plays in ACL strain during simulated landing. The hypothesis was that ACL strain would increase significantly in MCL-incompetent knees compared with the native knee and that reconstructing the MCL would return the values to those of the intact knee...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28165605/rotational-alignment-of-the-knee-is-different-in-osteological-specimens-with-and-without-a-large-cam-deformity-of-the-proximal-femur
#15
Jeremy J Gebhart, Jonathan J Streit, Avi Goodman, Jordan Etscheidt, Douglas S Weinberg, Asheesh Bedi, Shane J Nho, Michael J Salata
PURPOSE: We studied a large osteological collection for differences in knee rotation based upon the presence or absence of a large cam deformity of the proximal femur. METHODS: We obtained 357 matched tibiae and femora from the Hamann-Todd Osteological Collection and measured: femoral head-neck alpha angle, anteroposterior axis (or Whiteside's line) at the distal femur relative to the posterior condylar axis, and position of the tibial tubercle with respect to the posterior condylar axis of the proximal tibia...
February 2, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28159718/mechanical-function-near-defects-in-an-aligned-nanofiber-composite-is-preserved-by-inclusion-of-disorganized-layers-insight-into-meniscus-structure-and-function
#16
Sonia Bansal, Sai Mandalapu, Céline Aeppli, Feini Qu, Spencer E Szczesny, Robert L Mauck, Miltiadis H Zgonis
: The meniscus is comprised of circumferentially aligned fibers that resist the tensile forces within the meniscus (i.e., hoop stress) that develop during loading of the knee. Although these circumferential fibers are severed by radial meniscal tears, tibial contact stresses do not increase until the tear reaches ∼90% of the meniscus width, suggesting that the severed circumferential fibers still bear load and maintain the mechanical functionality of the meniscus. Recent data demonstrates that the interfibrillar matrix can transfer strain energy to disconnected fibrils in tendon fascicles...
January 31, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28159042/influence-of-lower-limb-rotation-on-hindfoot-alignment-using-a-conventional-two-dimensional-radiographic-technique
#17
L Baverel, J Brilhault, G Odri, M Boissard, François Lintz
BACKGROUND: Rotation is one of the variables explaining lack of reproducibility in assessing hindfoot alignment. The hypothesis for this study was that a mathematical model predicts how this modifies radiographic hindfoot alignment measurements. METHODS: A cadaveric lower limb, disjointed at knee level, was used. Sagittal and coronal planes were fixed using a custom clamp. Standard AP views were shot every five degrees and measured hindfoot alignments were compared to theoretical values obtained from a mathematical simulation...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28149734/medial-closing-wedge-distal-femoral-osteotomy-for-genu-valgum-with-lateral-compartment-disease
#18
James D Wylie, Travis G Maak
Lateral compartment disease combined with valgus alignment can lead to progressive knee joint degeneration. In the symptomatic patient with isolated lateral compartment disease, a varus-producing distal femoral osteotomy can unload the diseased lateral compartment. This osteotomy may be combined with other cartilage or meniscal restorative techniques to optimize knee joint preservation and pain relief. The osteotomy can be performed with a medial closing-wedge or lateral opening-wedge technique. Both techniques have been reported to improve knee-related quality of life in patients with lateral compartment disease...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28148655/meta-analysis-of-gap-balancing-versus-measured-resection-techniques-in-total-knee-arthroplasty
#19
REVIEW
T Huang, Y Long, D George, W Wang
AIMS: There are two techniques widely used to determine the rotational alignment of the components in total knee arthroplasty (TKA); gap balancing (GB) and measured resection (MR). Which technique is the best remains controversial. We aimed to investigate this in a systematic review and meta-analysis. MATERIALS AND METHODS: In accordance with the methods of Cochrane, databases were searched for all randomised controlled trials in the literature between January 1986 and June 2015 comparing radiographic and clinical outcomes between the use of these two tecniques...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28146438/morbid-obesity-and-total-knee-arthroplasty-a-growing-problem
#20
J Ryan Martin, Jason M Jennings, Douglas A Dennis
Obesity is an epidemic, with approximately 35% of the US population affected. This rate is unlikely to decline and may increase the demand for total knee arthroplasty (TKA). Data regarding the risks, benefits, and potential complications of TKA in this patient population are conflicting. Preoperative considerations are optimization of nutritional status, safe weight loss strategies, and bariatric surgery. Intraoperative concerns unique to this population include inadequate exposure, implant alignment, and durable implant fixation; postoperative issues include tibial loosening, wound complications, cardiovascular events, and respiratory complications...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
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