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Mechanical axis limbs

Koji Murakami, Satoshi Hamai, Ken Okazaki, Satoru Ikebe, Hidehiko Higaki, Takeshi Shimoto, Yasuharu Nakashima
PURPOSE: Neutral lower limb alignment does not necessarily produce a horizontal joint line after total knee arthroplasty (TKA). The orientation of the pre- and postoperative tibial mechanical axes (TMAs-G), tibial component, and joint line relative to the ground were evaluated. METHODS: The study group included 46 knees, 23 posterior-stabilized (PS) and 23 bicruciate-stabilized (BCS) TKAs. Using whole-leg standing radiographs, the static orientation of the pre- and postoperative TMAs-G and the tibial component as well as the postoperative alignment were measured...
March 20, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Matthew Morin, Joshua Klatt, Peter M Stevens
Proximal tibial metaphyseal fractures in children can lead to progressive and symptomatic tibial valgus. Corrective osteotomy has been abandoned, due to frequent complications, including recurrent valgus deformity. While spontaneous remodelling has been reported, this is not predictable. For children with persistent deformities, we have resorted to guided growth of the tibia. We present 19 patients who were successfully treated with guided growth, tethering the proximal medial physis. There were ten boys and nine girls, ranging in age from two to 13...
March 16, 2018: Strategies in Trauma and Limb Reconstruction
Christopher W Jones, Seth A Jerabek
BACKGROUND: Computer-assisted surgical (CAS) navigation has been developed with the aim of improving the accuracy and precision of total knee arthroplasty (TKA) component positioning and therefore overall limb alignment. The historical goal of knee arthroplasty has been to restore the mechanical alignment of the lower limb by aligning the femoral and tibial components perpendicular to the mechanical axis of the femur and tibia. Despite over 4 decades of TKA component development and nearly 2 decades of interest in CAS, the fundamental question remains; does the alignment goal and/or the method of achieving that goal affect the outcome of the TKA in terms of patient-reported outcome measures and/or overall survivorship? The quest for reliable and reproducible achievement of the intraoperative alignment goal has been the primary motivator for the introduction, development, and refinement of CAS navigation...
January 31, 2018: Journal of Arthroplasty
Robert G Willson, Regina O Kostyun, Matthew D Milewski, Carl W Nissen
Background: Reconstruction of the anterior cruciate ligament (ACL) in the skeletally immature patient is frequently performed in hopes of preventing new or additional chondral damage and meniscal injuries. Patients within a few years of skeletal maturity are more at risk for ACL injuries than prepubescent patients, about whom several physeal-sparing techniques have been described. Reconstruction techniques in the former higher risk group need to be better understood. Purpose: To review a series of adolescent patients with ACL injuries surgically treated with the hybrid physeal-sparing technique...
February 2018: Orthopaedic Journal of Sports Medicine
Christopher A Iobst, S Robert Rozbruch, Scott Nelson, Austin Fragomen
INTRODUCTION: Patients with limb-length discrepancies often have concomitant deformity. We describe the outcomes of acute, fixator-assisted deformity correction with gradual lengthening using the retrograde femoral Precice nail (NuVasive). METHODS: We analyzed a retrospective series of 27 patients in whom an external fixator was combined with a Precice nail to correct angular or rotational deformity and limb-length discrepancy. The fixator was applied temporarily to restore normal alignment...
February 27, 2018: Journal of the American Academy of Orthopaedic Surgeons
Kye-Youl Cho, Kang-Il Kim, Sang-Jun Song, Kyu-Jin Kim
Purpose: The purpose of this study was to determine the results of mobile bearing unicompartmental knee arthroplasty (UKA) with an intentionally increased flexion angle of the femoral component in patients requiring high flexion. Materials and Methods: We investigated 45 knees treated by UKA. Clinically, we measured the range of motion (ROM) and the American Knee Society (AKS) score preoperatively and at final follow-up and investigated complications. Radiologically, we measured the flexion angle of the femoral component, the posterior slope angle of the tibial component, the femorotibial angle and mechanical axis of the limb postoperatively...
March 1, 2018: Knee Surgery & related Research
Henrik Dimke, Jürgen Schnermann
The thick ascending limb (TAL) extends from the border of the inner medulla to the renal cortex, thus ascending through regions with wide differences in tissue solute and electrolyte concentrations. Structural and functional differences between TAL cells in the medulla (mTAL) and the cortex (cTAL) would therefore be useful to adapt TAL transport function to a changing external fluid composition. While mechanisms common to all TAL cells play a central role in the reclamation of about 25% of the NaCl filtered by the kidney, morphological features, Na+ / K+ -ATPase activity, NKCC2 splicing and phosphorylation does vary between segments and cells...
February 24, 2018: Acta Physiologica
Johannes Cip, Florian Obwegeser, Thomas Benesch, Christian Bach, Paul Ruckenstuhl, Arno Martin
BACKGROUND: Navigated computer-assisted total knee arthroplasty (TKA) was introduced to expedite long-term survival based on improved postoperative implantation accuracy. However, long-term outcome data after 10 years or more are rare, even available meta-analyses show controversial study results. METHODS: In a prospective randomized trial, 100 conventional TKAs (group CONV) were compared with 100 computer-assisted TKAs (group NAV) after a mean follow-up of 12 years postoperatively...
December 21, 2017: Journal of Arthroplasty
Michael A Miranda, Joseph P DeAngelis, George H Canizares, Jeffery W Mast
OBJECTIVE: To evaluate the outcomes of a double oblique osteotomy for the management of distal femoral malunions and a combination malunion/nonunion. DESIGN: Case series. SETTING: Level 1/2 hospital. PATIENTS/PARTICIPANTS: Ten patients with a mean age of 50 years (range 30-69 years) with posttraumatic deformities of the distal femur. INTERVENTION: A 2-level, length-sparing osteotomy was performed in accordance with a detailed preoperative plan for correction of the mechanical axis in a distal femoral deformity...
February 2018: Journal of Orthopaedic Trauma
Vincent Hernandez, Philippe Gorce, Nasser Rezzoug
The aim of this work was to assess handrim wheelchair propulsion effectiveness, related to the applied forces on the handrim, through the force feasible set. For a given posture of the upper-limb, it represents the set of isometric forces that can be applied on the handrim in any direction. The force feasible set was predicted from a musculoskeletal model of the upper-limb and trunk (10 degrees of freedom and 56 muscles). The aim of the first part of the study was to compare the force feasible set prediction and the force currently applied on the handrim...
December 15, 2017: Journal of Biomechanics
C Orellana-Reta, L A Valdez-Jiménez
OBJECTIVE: The aim of this study was to evaluate the functional and radiographic results of adolescent patients with angular deformities of the pelvic limbs treated with an open wedge osteotomy system. MATERIAL AND METHODS: Observational, prospective, analytical and cross-sectional study of patients with angular deformity of the pelvic limbs treated with an open wedge osteotomy. We made a radiographic evaluation of the femorotibial angle, MAD angle, lower limb discrepancy, and pre- and postoperative degrees of the rotational center of deformity (CORA), as well as a telephone survey of the postoperative functional evaluation IKDC 2000...
May 2017: Acta Ortopédica Mexicana
Yasuo Niki, Takeo Nagura, Katsuya Nagai, Shu Kobayashi, Kengo Harato
PURPOSE: Knee adduction moment (KAM) has been recognized as a good clinical surrogate for medial tibiofemoral joint loading and is associated with implant durability after total knee arthroplasty (TKA). This study aimed to examine the effects of joint line obliquity in kinematically aligned TKA (KA-TKA) on KAM during gait. METHODS: The study enrolled 21 knees from 18 patients who underwent cylindrical axis reference KA-TKA and a matched group of 21 knees from 18 patients who underwent mechanically aligned (MA)-TKA as controls...
December 4, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Seung-Beom Han, Hyun Jung Kim, Dae-Hee Lee
Background: It is unclear whether computer navigation can improve the accuracy and reliability of targeted lower limb alignment correction following open-wedge high tibial osteotomy (HTO). This meta-analysis was designed to compare the accuracy and reliability of limb alignment correction between computer navigated and conventional open-wedge HTOs. Methods: Studies that compared postoperative coronal alignment, including mechanical axis (MA) and weight bearing line (WBL) ratio, outliers of alignment correction, and change in tibial posterior slope, following open-wedge HTO performed using computer navigated and conventional methods were included...
2017: BioMed Research International
J T Ren, C Xu, J S Wang, X L Liu
Objective: To evaluate the effects of three-dimensional printing patient-specific instrumentation(PSI) versus conventional instrumentation(CI) in the total knee arthroplasty. Methods: According to "patient-specific" , "patient-matched" , "custom" , "Instrumentation" , "Guide Instrumentation" , "cutting blocks" , "total knee arthroplasty" , "total knee replacement" , "TKA" and "TKR" , the literature on PubMed, EMbase, Cochrane library, CBM and WanFang were searched. According to the inclusion and exclusion criteria, the high quality randomized control trial (RCT) studies about three-dimensional (3D) printing patient-specific instrumentation versus conventional instrumentation in the total knee arthroplasty were collected...
October 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Seshadri Raju, William Crim, William Buck
BACKGROUND: Peripheral venous hypertension and microvascular injury have merged as central features of chronic venous disease. Peripheral venous pressure in the lower limb is controlled by central and peripheral mechanisms. In the current manuscript, we examine the role of peripheral factors, particularly conduit capacitance compliance, focal stenosis, and arterial inflow into the calf. METHODS: An experimental venous model using Penrose tubing as a venous analogue was used where the aforementioned parameters could be manipulated...
November 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Omer Slevin, Anna Hirschmann, Filippo F Schiapparelli, Felix Amsler, Rolf W Huegli, Michael T Hirschmann
PURPOSE: The optimal coronal alignment is still under debate. However, in most of the studies, alignment was only assessed using radiographs, which are not accurate enough for assessment of tibial and femoral TKA position. The primary purpose of this study was to assess the relationship between coronal TKA alignment using 3D-reconstructed CTs and clinical outcome in patients with preoperative varus in comparison with patients with natural or valgus deformity. It was the hypothesis that neutral limb alignment shows a better outcome after TKA...
October 12, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Stefania Pinna, Noemi Romagnoli
The direction of the force of the quadriceps muscle group is expressed by the value of the quadriceps angle, between the long axis of the muscle rectus femoris and the patellar ligament. This value is often modified in dogs with patellar luxation, a common orthopaedic disease of the stifle joint in both small and large dogs. The aims of the present study were to give a reference value for the quadriceps angle in healthy small and medium-large breed dogs. The medical records of healthy dogs and their pelvic limb radiographs (2014-2016) were reviewed...
2017: PloS One
Nathan M Young
Reconciling the origins of morphological diversity with the deep homology of underlying mechanisms is a question fundamental to the goals of evolutionary developmental biology ("evo-devo" or EDB). In this paper I argue that differing research agendas in evolutionary and developmental biology have hindered how we address this question, but that the limb provides ideal "common ground" for their fuller integration. To support this idea, I review two previous analyses of limb variation in mammal, bird, and reptile taxa that offer complementary approaches to explaining diversity...
September 6, 2017: Integrative and Comparative Biology
Mehdi Moghtadaei, Ali Yeganeh, Bahram Boddouhi, Atefe Alaee, Hossein Farahini, Babak Otoukesh
BACKGROUND AND AIMS: The aim of this study is to evaluate the effect of proximal tibia osteotomy on hip biomechanics. METHODS: This cohort study was conducted on 50 knees of 37 patients divided into two groups of unilateral and bilateral surgeries during 2015-2016. Patients underwent medial open-wedge osteotomy of proximal tibia. Axial alignment of lower limb radiography was carried out for the patients before and after the osteotomy. RESULTS: Findings from unilateral and bilateral high tibial osteotomies demonstrated that the average of greater trochanter (GT) angle from femoral head center and also the average angle of knee varus were significantly decreased (P = 0...
June 2017: Interventional Medicine & Applied Science
Seyyed Morteza Kazemi, Tooraj Shafaghi, Reza Minaei, Reza Osanloo, Hashem Abrishamkarzadeh, Farshad Safdari
In the current study, we investigated that how sagittal femoral bowing can affect the sagittal alignment of the femoral component in total knee arthroplasty (TKA). There were 25 patients underwent TKA. Long leg radiography in lateral view was performed. The sagittal femoral bowing (SFB) and component alignment in relation to the sagittal mechanical axis and distal anterior cortical line (DACL) were measured. Finally, the correlation of component alignment and SFB was examined. Mean SFB was 7±2.7 degrees. The component was in flexion position in relation to mechanical axis and DACL as 8...
July 2017: Archives of Bone and Joint Surgery
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