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Tibia component rotation

Seung-Yup Lee, Hong-Chul Lim, Ki-Mo Jang, Ji-Hoon Bae
BACKGROUND: When using the gap-balancing technique for TKA, excessive medial release and varus proximal tibial resection can be associated with internal rotation of the femoral component. Previous studies have evaluated the causes of femoral component rotational alignment with a separate factor analysis using unadjusted statistical methods, which might result in treatment effects being attributed to confounding variables. QUESTIONS/PURPOSES: (1) What pre- and intraoperative factors are associated with internal rotation of the femoral component in TKA using the gap balancing technique? (2) To what degree does femoral component rotation as defined by the navigation system differ from rotation as measured by postoperative CT? METHODS: Three hundred seventy-seven knees that underwent computer-assisted primary TKA attributable to degenerative osteoarthritis with varus or mild valgus alignment in which medial soft tissue release was performed, and those with preoperative radiographs including preoperative CT between October 2007 and June 2014 were included in the study...
March 23, 2017: Clinical Orthopaedics and related Research
Timothy Lording, Shaun K Stinton, Philippe Neyret, Thomas P Branch
PURPOSE: The purpose of this study was to evaluate the separate contribution of the two definitions of the anterolateral ligament (ALL), the mid-third lateral capsular ligament (MTLCL) and deep capsule-osseous layer of the iliotibial tract (dcITT) in addition to the superficial iliotibial tract (sITT) to the control of tibial motion with respect to the femur during the application of force/torque seen during the three tests of the standard clinical knee examination (AP Lachman test, tibial axial rotation test and varus-valgus stress test)...
March 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Soheil Sabzevari, Amir Ata Rahnemai-Azar, Marcio Albers, Monica Linde, Patrick Smolinski, Freddie H Fu
BACKGROUND: There is currently disagreement with regard to the presence of a distinct ligament in the anterolateral capsular complex of the knee and its role in the pivot-shift mechanism and rotatory laxity of the knee. PURPOSE: To investigate the anatomic and histological properties of the anterolateral capsular complex of the fetal knee to determine whether there exists a distinct ligamentous structure running from the lateral femoral epicondyle inserting into the anterolateral tibia...
March 1, 2017: American Journal of Sports Medicine
Joshua D Roth, Stephen M Howell, Maury L Hull
Previous reports of tibial force sensors have neither characterized nor corrected errors in the computed contact location between the femoral and tibial components in total knee arthroplasty (TKA) that are theoretically caused by the curved articular surface of the tibial component. The objectives were to experimentally characterize there errors and to develop and validate an error correction algorithm. The errors were characterized by calculating the difference between the errors in the computed contact location when forces were applied normal to the tibial articular surface and those when forces were applied normal to the tibial baseplate...
March 7, 2017: Journal of Biomechanical Engineering
Adam J Schwartz, Bheeshma Ravi, Mark J Kransdorf, Henry D Clarke
BACKGROUND: A standing anteroposterior (AP) radiograph is commonly used to evaluate coronal alignment following total knee arthroplasty (TKA). The impact of coronal alignment on TKA outcomes is controversial, perhaps due to variability in imaging and/or measurement technique. We sought to quantify the effect of image rotation and tibial slope on coronal alignment. METHODS: Using a standard extramedullary tibial alignment guide, 3 cadaver legs were cut to accept a tibial tray at 0°, 3°, and 7° of slope...
February 10, 2017: Journal of Arthroplasty
Alexander R Mait, Adwait Mane, Jason L Forman, John Paul Donlon, Bingbing Nie, Richard W Kent
The purpose of this study was to determine the long-time and transient characteristics of the moment generated by external (ER) and internal (IR) rotation of the calcaneus with respect to the tibia. Two human cadaver legs were disarticulated at the knee joint while maintaining the connective tissue between the tibia and fibula. An axial rotation of 21° was applied to the proximal tibia to generate either ER or IR while the fibula was unconstrained and the calcaneus was permitted to translate in the transverse plane...
February 28, 2017: Journal of Biomechanics
Alessandro Ortolani, Roberto Bevoni, Alessandro Russo, Maurilio Marcacci, Mauro Girolami
Isolated posteromedial ankle dislocation is a rare condition thanks to the highly congruent anatomical configuration of the ankle mortise, in which the medial and lateral malleoli greatly reduce the rotational movement of the talus, and the strength of the ligaments higher than the malleoli affords protection against fractures. However, other factors, like medial malleolus hypoplasia, laxity of the ligaments, peroneal muscle weakness and previous ankle sprains, could predispose to pure dislocation. In the absence of such factors, only a complex high-energy trauma, with a rotational component, can lead to this event...
July 2016: Joints
Kyoung-Tak Kang, Juhyun Son, Oh-Ryong Kwon, Changhyun Baek, Dong Beom Heo, Kyoung-Mi Park, Ho-Joong Kim, Yong-Gon Koh
BACKGROUND: There have been arguments for methodology in tibial rotation axis measurement, which accordingly determines the morphometry of the proximal tibia in total knee arthroplasty. The morphometry of the proximal tibia for the Korean population is determined by gender, based on the anatomical tibial axis and reliable rotational orientation in knee replacements, to evaluate the size suitability of the currently available prostheses in Korea. METHODS: This study reconstructed the MRI images in three-dimensions for identification and measurement of the mediolateral (ML) and anteroposterior (AP) lengths of the proximal tibia and the tibial aspect ratio (ML/AP) using proximal tibial anthropometric data for 700 osteoarthritic knees (587 females and 113 males)...
November 5, 2016: Knee
Guenther Maderbacher, Clemens Baier, Hans-Robert Springorum, Hermann Maderbacher, Anne-Maria Birkenbach, Achim Benditz, Joachim Grifka, Armin Keshmiri
Correct rotational implant alignment is associated with increased postoperative function and implant survival in total knee arthroplasty (TKA). Due to conformity between tibial and femoral implants, particularly in full extension, we assumed a mutual interference of femoral and tibial component rotations. We, therefore, hypothesized that different rotational alignments of the tibial or femoral components change the rotational postures between the tibia and femur after TKA. In 10 healthy knees of whole body cadavers, TKA was performed...
September 19, 2016: Journal of Knee Surgery
Carlos Martin-Hernandez, Luis Javier Floria-Arnal, Maria Pilar Muniesa-Herrero, Teresa Espallargas-Doñate, Jose Adolfo Blanco-Llorca, Melchor Guillen-Soriano, Miguel Ranera-Garcia
PURPOSE: Metaphyseal titanium sleeves have been used to provide cementless fixation in challenging bone defects in revision knee arthroplasty. The aim of this study was to evaluate the mid-term results of radiological and clinical outcomes, for metaphyseal sleeves in type 1B and 2 defects of tibia and femur under the hypothesis that they would provide stable and prolonged fixation. METHODS: One hundred and thirty-four patients were included in a prospective study to evaluate the outcomes of knee revision with sleeves, together with stems and varus-valgus constrained mobile bearing prosthesis...
September 17, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
N Pourgiezis, S P Reddy, M Nankivell, G Morrison, J VanEssen
PURPOSE: To compare patient-matched instrumentation (PMI) with conventional total knee arthroplasty (TKA) in terms of limb alignment and component position. METHODS: Nine men and 36 women (mean age, 69.5 years) who underwent PMI TKA were compared with 20 men and 25 women (mean age, 69.3 years) who underwent conventional TKA by the same team of surgeons with the same prosthesis and protocols in terms of limb alignment and component position using the Perth protocol computed tomography, as well as bone resection measurements, operating time, and the number of trays used...
August 2016: Journal of Orthopaedic Surgery
Nienke M Kosse, Gijs G van Hellemondt, Ate B Wymenga, Petra J C Heesterbeek
BACKGROUND: Short-term stability after revision total knee arthroplasty (TKA) with either fully cemented or hybrid-placed implants is comparable. Interestingly, implant micromotion >1 mm/degree occurred with both techniques which might increase the risk of loosening in the midterm or long-term. Therefore, the present study investigated midterm stability and clinical results of fully cemented vs hybrid-placed revision TKA, with mild to moderate bone loss, using radiostereometric analysis (RSA)...
January 2017: Journal of Arthroplasty
David Hudson
The purpose of this study was to compare the rotational profile of adults with higher versus lower foot progression angles (FPA). Tibial torsion, femoral torsion, hip internal and external rotation and FPA data were collected on one hundred two healthy volunteers. Data were stratified into Low, Mid, and High FPA groups to study relationships among the components of the rotational profile and if there were group differences in the magnitude of torsion angles. Direction of torsion was also studied as an attempt to look at the incidence of offsetting between the tibia and femur...
September 2016: Gait & Posture
Christian Benzing, Adrian Skwara, Jens Figiel, Jürgen Paletta
INTRODUCTION: Cementless fixation of the tibial component is critical as reduced initial stability leads to implant failure. In this experimental in vitro study, a new fixation method of the tibial component using polyaxial locking screws is evaluated using Roentgen stereophotogrammetric analysis (RSA). MATERIALS AND METHODS: A special prototype of a tibial component with four polyaxial locking screws was tested on 10 fresh-frozen human tibia specimens. The components were tested with an axial load of 2000 N for 10,000 cycles...
September 2016: Archives of Orthopaedic and Trauma Surgery
Naohisa Miyatake, Takehiko Sugita, Toshimi Aizawa, Akira Sasaki, Ikuo Maeda, Masayuki Kamimura, Hirokazu Fujisawa, Atsushi Takahashi
BACKGROUND: Precise matching of the tibial component and resected bony surfaces and proper rotational implanting of the tibial component are crucial for successful total knee arthroplasty. We aimed to analyze the exact anthropometric proximal tibial data of Japanese patients undergoing total knee arthroplasty and correlate the measurements with the dimensions of current total knee arthroplasty systems. METHODS: A total of 703 knees in 566 Japanese patients who underwent total knee arthroplasty for osteoarthritis were included...
September 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Guenther Maderbacher, Armin Keshmiri, Hans R Springorum, Felix Greimel, Joachim Grifka, Clemens Baier
BACKGROUND: In comparison to coronal, sagittal, and rotational alignment, translational alignment parameters have been widely neglected in total knee arthroplasty (TKA) so far. As there is a certain variable range of possible component placement in mediolateral, ventrodorsal, and proximodistal direction, we hypothesized that relative positions between the femoral and tibial bones are changed after TKA, resulting in a subluxation of knees. METHODS: In 10 knees of Thiel-embalmed whole body cadavers, the relative position between the femur and the tibia during passive flexion was measured before and after TKA by means of a navigational device...
January 2017: Journal of Arthroplasty
Seung-Yup Lee, Suhwoo Chay, Hong-Chul Lim, Ji-Hoon Bae
PURPOSE: No "ideal" landmark for tibial component rotation in medial unicompartmental knee arthroplasty (UKA) has been suggested by a biomechanical and clinical study. The aim of this study was to investigate whether the anterior superior iliac spine (ASIS) could provide a consistent rotational landmark of the tibial component during mobile-bearing medial UKA using computed tomography (CT). METHODS: During sagittal tibial resection, we utilized the ASIS as a rotational landmark...
June 8, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Won Seok Oh, Yong Seuk Lee, Byung Kak Kim, Jae Ang Sim, Beom Koo Lee
PURPOSE: To analyze the contact mechanics of the femoral component and polyethylene of the Low Contact Stress rotating platform (LCS-RP) in nonweight bearing and weight bearing conditions using full flexion lateral radiographs. MATERIALS AND METHODS: From May 2009 to December 2013, 58 knees in 41 patients diagnosed with osteoarthritis and treated with total knee arthroplasty (TKA) were included in this study. TKA was performed using an LCS-RP knee prosthesis. Full flexion lateral radiographs in both weight bearing and nonweight bearing condition were taken at least one month postoperatively (average, 28...
June 2016: Knee Surgery & related Research
Kazuhisa Hatayama, Masanori Terauchi, Kenichi Saito, Keiichi Hagiwara, Hiroshi Higuchi
BACKGROUND: The tibial tubercle (TT) is the most reliable landmark of the tibial component rotation in total knee arthroplasty. However, there is no report comparing the position of the TT between valgus and varus osteoarthritic knees. METHODS: Using preoperative computed tomography, we measured the TT-posterior cruciate ligament (PCL) distance representing the degree of lateralization of the TT and the angle between Akagi's anteroposterior (AP) axis and the dorsal condylar line (DCL) of the tibia in 36 valgus and 40 varus osteoarthritic knees and compared them...
October 2016: Journal of Arthroplasty
Tsung-Yuan Tsai, Dimitris Dimitriou, Ali Hosseini, Ming Han Lincoln Liow, Martin Torriani, Guoan Li, Young-Min Kwon
This study aimed to evaluate the precision and accuracy of 3D reconstruction of UKA component position, contact location and lower limb alignment in standing position using biplanar radiograph. Two human specimens with 4 medial UKAs were implanted with beads for radiostereometric analysis (RSA). The specimens were frozen in standing position and CT-scanned to obtain relative positions between the beads, bones and UKA components. The specimens were then imaged using biplanar radiograph (EOS). The positions of the femur, tibia, UKA components and UKA contact locations were obtained using RSA- and EOS-based techniques...
July 2016: Medical Engineering & Physics
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