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Tibia component rotation

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)...
July 14, 2016: 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...
June 11, 2016: 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
S R Small, R D Rogge, R A Malinzak, E M Reyes, P L Cook, K A Farley, M A Ritter
OBJECTIVES: Initial stability of tibial trays is crucial for long-term success of total knee arthroplasty (TKA) in both primary and revision settings. Rotating platform (RP) designs reduce torque transfer at the tibiofemoral interface. We asked if this reduced torque transfer in RP designs resulted in subsequently reduced micromotion at the cemented fixation interface between the prosthesis component and the adjacent bone. METHODS: Composite tibias were implanted with fixed and RP primary and revision tibial trays and biomechanically tested under up to 2...
April 2016: Bone & Joint Research
Seung-Yup Lee, Ji-Hoon Bae, Dong-Won Suh, Han-Ju Kim, Hong-Chul Lim
This mediolateral excursion of the bearing during knee motion is supposed to be caused by external rotation of the tibia during knee extension. However, to our knowledge, there is no published clinical evidence supporting these hypotheses. The current study aimed to evaluate the mediolateral excursion of the bearing during flexion-extension motion of the knee after medial unicompartmental knee arthroplasty (UKA). In 52 knees, varus/valgus (F-VarVal) or rotational position (F-Rot) of the femoral component and relative location of the bearing were measured with the standing anteroposterior and modified axial view, respectively...
April 18, 2016: Journal of Knee Surgery
Altaf Ahmad Kawoosa, Iftikhar H Wani, Fiaz Ahmad Dar, Asif Sultan, Manan Qazi, Manzoor Ahmad Halwai
BACKGROUND: The aim of the study was to retrospectively analyse the long term clinical outcome, accuracy of correction, and the complication rate in patients treated for deformities around the knee with gradual distraction with or without additional limb lengthening using Ilizarov technique. MATERIAL AND METHODS: The study presents a retrospective analysis of 26 patients treated for deformities about the knee by gradual distraction with Ilizarov technique with an average follow-up of 6...
November 2015: Ortopedia, Traumatologia, Rehabilitacja
Yuchi Zhao, Shijun Wang, Zhongyuan Zhao, Kun Song, Shudong Zhang
OBJECTIVE: To investigate the influences of the distal femoral cut, the anterior and posterior femoral cuts, the proximal tibial cut on the dynamic alignment of the lower extremity in total knee arthroplasty. METHODS: Based on the three-dimensional geometric model, imitating the flexion movement of the knee without axial rotation after total knee arthroplasty, the influence of each of the three bone cuts on the dynamic alignment was analyzed with the assumption of standard bone cuts of the other two and equality of the medial and lateral soft tissue balancing...
April 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Michael Drexler, David Backstein, Ueli Studler, Dror Lakstein, Barak Haviv, Ran Schwarzkopf, Tal Frenkel Rutenberg, Yaniv Warschawski, Ehud Rath, Yona Kosashvili
PURPOSE: The objective of this study was to quantify the amount of ensuing internal rotation of the tibial component when positioned along the medial border of the tibial tubercle, thus establishing a reproducible intraoperative reference for tibial component rotational alignment during total knee arthroplasty (TKA). METHODS: The angle formed from the tibial geometric centre to the intersection of both lines from the middle of the tibial tuberosity and its medial border was measured in 50 patients...
March 26, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Guenther Maderbacher, Clemens Baier, Hans R Springorum, Florian Zeman, Joachim Grifka, Armin Keshmiri
BACKGROUND: During flexion, normal knee kinematics consists of a complex combination of rolling, gliding, and rotation between femur and tibia. Although in vivo studies have shown wide interindividual variability, we hypothesized that knee kinematics is either correlated to the anatomy of the individual knee joint or to the anatomic alignment of the entire lower extremity. METHODS: The passive kinematics of 10 healthy knees was assessed in whole cadavers using a commercial computed tomography-free navigation device with intracortical pins...
September 2016: Journal of Arthroplasty
Peter Z Feczko, Bart G Pijls, Michael J van Steijn, Lodewijk W van Rhijn, Jacobus J Arts, Peter J Emans
BACKGROUND: Both the range of motion (ROM) technique and the tibial tubercle landmark (TTL) technique are frequently used to align the tibial component into proper rotational position during total knee arthroplasty (TKA). The aim of the study was to assess the intra-operative differences in tibial rotation position during computer-navigated primary TKA using either the TTL or ROM techniques. The ROM technique was hypothesized to be a repeatable method and to produce different tibial rotation positions compared to the TTL technique...
2016: BMC Musculoskeletal Disorders
Abheetinder S Brar, Stephen M Howell, Maury L Hull
BACKGROUND: Internal-external (I-E) malrotation of the tibial component is associated with poor function after total knee arthroplasty (TKA). Kinematically aligned (KA) TKA uses a functionally defined flexion-extension (F-E) tibial reference line, which is parallel to the F-E plane of the extended knee, to set I-E rotation of the tibial component. METHODS: Sixty-two, three-dimensional bone models of normal knees were analyzed. We computed the bias (mean), imprecision (±standard deviation), and limits of agreement (mean±2 standard deviations) of the angle between five anatomically defined tibial reference lines used in mechanically aligned (MA) TKA and the F-E tibial reference line (+external)...
June 2016: Knee
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