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https://www.readbyqxmd.com/read/28302462/the-impact-of-mechanical-and-restricted-kinematic-alignment-on-knee-anatomy-in-total-knee-arthroplasty
#1
Abdulaziz M Almaawi, Jonathan R B Hutt, Vincent Masse, Martin Lavigne, Pascal-Andre Vendittoli
BACKGROUND: Total knee arthroplasty (TKA), aiming at neutral mechanical alignment (MA), inevitably modifies the patient's native knee anatomy. Another option is kinematic alignment (KA), which aims to restore the original anatomy of the knee. The aim of this study was to evaluate the variations in lower limb anatomy of a patient population scheduled for TKA, and to assess the use of a restricted KA TKA protocol and compare the resulting anatomic modifications with the standard MA technique...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28299385/no-impact-of-under-correction-and-joint-line-obliquity-on-clinical-outcomes-of-total-knee-arthroplasty-for-the-varus-knee
#2
Richard D Rames, Michael Mathison, Zachary Meyer, Robert L Barrack, Denis Nam
PURPOSE: It has been hypothesized that under-correction of a preoperative varus deformity may be more natural and improve outcomes after total knee arthroplasty (TKA). This study's purpose was to assess the impact of hip-knee-ankle (HKA) alignment and joint line obliquity on TKA outcomes for the varus knee. METHODS: All patients with a preoperative varus deformity received both preoperative and postoperative standing, full-length radiographs from which two independent observers performed radiographic measurements including the HKA axis and mechanical medial proximal tibial angle (mMPTA)...
March 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28276647/clinical-comparison-of-extensile-lateral-approach-and-sinus-tarsi-approach-combined-with-medial-distraction-technique-for-intra-articular-calcaneal-fractures
#3
Hai-Chao Zhou, Tao Yu, Hao-Yang Ren, Bing Li, Kai Chen, You-Guang Zhao, Yun-Feng Yang
OBJECTIVE: To study and compare the clinical outcomes of open reduction and internal fixation via extensile L-shape incision and limited open reduction via the sinus tarsi approach using the medial distraction technique for intra-articular calcaneal fractures. METHODS: We performed a retrospective review of 65 intra-articular calcaneal fractures treated operatively between March 2012 and February 2015. Patients were divided into two groups: 28 were in the sinus tarsi approach group and 37 were in the extensile lateral approach group...
March 9, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28253941/arthrodesis-of-the-ankle
#4
H Zwipp
About 90 % of all cases of painful posttraumatic ankle arthritis can be very successfully treated with a minor invasive ankle arthrodesis technique by using a small anterior approach and a fixation with four 6. 5 mm screws of which the posteromedial and transfibular one are inserted percutaneously. The results with this standardized procedure have been reported previously as excellent and good in a mid-term run of 6 years (34). This technique leads to a high union rate of 99% (92 of 93) with rapid bone healing within 8 ± 2 weeks, it causes a low minor complication rate of 8 % and enables a significant increase of the AOFAS ankle/hindfoot score (17) from 36 preoperatively to 85 postoperatively as well as a midtarsal movement of 24° ± 16°...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28231959/obtaining-correct-ankle-alignment-using-intraoperative-external-fixation-for-ankle-arthrodesis
#5
Reza Firoozabadi, Daniel Thuillier, Stephen Benirschke
Ankle arthrodesis remains an important treatment option for patients with ankle arthritis. Many methods have been described; however, no consensus has been reached regarding the best technique to achieve both successful fusion and a good position for optimal foot mechanics. Furthermore, as arthroplasty has become more popular, preservation of the fibula to allow for future arthroplasty has become critical. The present report describes an innovative technique in which temporary external fixation at operative fixation is used, along with internal fixation, to achieve both an optimal foot position and high fusion rates, while maintaining the integrity of the fibula...
March 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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
#6
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/28185754/does-residual-varus-alignment-cause-increasing-varus-laxity-at-a-minimum-of-five-years-after-total-knee-arthroplasty
#7
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/28183212/3d-biometrics-for-hindfoot-alignment-using-weightbearing-ct
#8
François Lintz, Matthew Welck, Alessio Bernasconi, James Thornton BSc, Nicholas P Cullen, Dishan Singh, Andy Goldberg
BACKGROUND: Hindfoot alignment on 2D radiographs can present anatomical and operator-related bias. In this study, software designed for weightbearing computed tomography (WBCT) was used to calculate a new 3D biometric tool: the Foot and Ankle Offset (FAO). We described the distribution of FAO in a series of data sets from clinically normal, varus, and valgus cases, hypothesizing that FAO values would be significantly different in the 3 groups. METHODS: In this retrospective cohort study, 135 data sets (57 normal, 38 varus, 40 valgus) from WBCT (PedCAT; CurveBeam LLC, Warrington, PA) were obtained from a specialized foot and ankle unit...
February 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28182859/radiographic-study-of-pes-planovarus
#9
Janic Aebi, Monika Horisberger, Arno Frigg
BACKGROUND: Depending on the direction of the subtalar joint, a foot deformity generally tends towards pronation (pes planovalgus) or supination (pes cavovarus). However, the combination of hindfoot varus and flat midfoot/forefoot (pes planovarus) is an exception to this rule. Pes planovarus has so far only been referred to in connection with Müller-Weiss disease and congenital disease. We diagnosed pes planovarus in otherwise healthy patients without these diseases. METHODS: Forty patients with 54 symptomatic feet who were treated between August 2012 and July 2016 were included (mean age, 44...
February 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28169136/in-vitro-wear-of-ultrahigh-molecular-weight-polyethylene-and-vitamin-e-blended-highly-cross-linked-polyethylene-in-linked-semiconstrained-total-elbow-replacement-prostheses
#10
Oludele O Popoola, Brian L Kincaid, Kimberly Mimnaugh, Mark Marqueling
BACKGROUND: The objectives of this study were to develop a clinically relevant in vitro elbow wear test and to compare the polyethylene wear of 2 total elbow replacement prostheses, one that uses conventional gamma-irradiated polyethylene (CPE) and one that uses vitamin E blended and cross-linked polyethylene (VE-HXPE) bushings. MATERIALS AND METHODS: The test protocol applied 0° to 85° flexion-extension motions and imposed a constant 4.5° varus malalignment of the ulnar relative to the humeral implant under a variable joint load profile at a frequency of 1 Hz...
February 3, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28144722/presence-of-rotational-errors-in-long-leg-radiographs-after-total-knee-arthroplasty-and-impact-on-measured-lower-limb-and-component-alignment
#11
Günther Maderbacher, Clemens Baier, Achim Benditz, Ferdinand Wagner, Felix Greimel, Joachim Grifka, Armin Keshmiri
PURPOSE: Rotation of the lower limb in weight bearing long leg radiographs has a great impact on measured component and lower limb alignment parameters. We asked which rotational errors of long leg radiographs are present in a high volume centre and which radiological and clinical consequences arise regarding measured coronal component and lower limb alignment after total knee arthroplasty. METHODS: In 100 long leg radiographs coronal femoral and tibial component alignment and hip knee ankle angle (HKA) were measured...
January 31, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28142302/outcomes-of-modified-metatarsal-shortening-offset-osteotomy-for-forefoot-deformity-in-patients-with-rheumatoid-arthritis-short-to-mid-term-follow-up
#12
Makoto Hirao, Kosuke Ebina, Hideki Tsuboi, Akihide Nampei, Junichi Kushioka, Takaaki Noguchi, Shigeyoshi Tsuji, Hajime Owaki, Jun Hashimoto, Hideki Yoshikawa
OBJECTIVES: Advances in drug therapy for rheumatoid arthritis (RA) have been encouraging us to preserve the metatarsopharangeal (MTP) joint in correction of forefoot deformities, and original metatarsal shortening offset osteotomy was recommended as one of the conventional surgical options for forefoot deformities in RA cases. The objective of this study was to evaluate short- to mid-term outcomes of modified metatarsal shortening offset osteotomy. METHODS: A retrospective observational study was completed for 80 RA cases (mean follow-up period: 3...
February 1, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28120496/effects-of-active-feedback-gait-retraining-to-produce-a-medial-weight-transfer-at-the-foot-in-subjects-with-symptomatic-medial-knee-osteoarthritis
#13
Jennifer C Erhart-Hledik, Jessica L Asay, Caitlin Clancy, Constance R Chu, Thomas P Andriacchi
This study aimed to determine if active feedback gait retraining to produce a medial weight transfer at the foot significantly reduces the knee adduction moment in subjects with medial compartment knee osteoarthritis. Secondarily, changes in peak knee flexion moment, frontal plane knee and ankle kinematics, and center of pressure were investigated. Ten individuals with medial compartment knee osteoarthritis (9 males; age: 65.3 ± 9.8 years; BMI: 27.8 ± 3.0 kg/m(2) ) were tested at self-selected normal and fast speeds in two conditions: Intervention, with an active feedback device attached to the shoe of their more affected leg, and control, with the device de-activated...
January 24, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28117217/experience-of-total-knee-arthroplasty-using-a-novel-navigation-system-within-the-surgical-field
#14
Richard Niehaus, David Schilter, Paolo Fornaciari, Christian Weinand, Marcus Boyd, Marcel Ziswiler, Stefan Ehrendorfer
BACKGROUND: With the aim of improving component alignment and outcome in total knee arthroplasty (TKA), several computer-assisted devices (CAD) have been developed. METHODS: In February 2014, the present unit started to use a new imageless navigation system with accelerometric pods within the surgical field for all primary TKAs; there was no need for optical trackers or cameras. This paper presents the results of the first 72 TKAs using this iAssist system in 71 prospectively collected and retrospectively analyzed patients...
January 20, 2017: Knee
https://www.readbyqxmd.com/read/28111159/benefit-of-adding-fibular-osteotomy-to-open-wedge-valgus-distal-tibial-osteotomy-for-correcting-varus-ankle-arthritis-an-in%C3%A2-vitro-study
#15
Thos Harnroongroj, Bavornrit Chuckpaiwong
Early-stage varus ankle arthritis can usually be treated with a medial, open-wedge, valgus, distal tibial osteotomy; however, the value of adding a fibular osteotomy has been debated. We sought to determine the increase in the maximum medial osteotomy gap and correction angle provided by fibular osteotomy. In 3 sequential experiments on 12 fresh cadaveric legs, we first performed a medial open-wedge, valgus, distal tibial osteotomy alone. Second, we added a transverse fibular osteotomy. Finally, we added a blocked fibular osteotomy...
March 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28110363/bone-morphotypes-of-the-varus-and-valgus-knee
#16
E Thienpont, P E Schwab, O Cornu, J Bellemans, J Victor
BACKGROUND: Coronal deformity correction with total knee arthroplasty (TKA) is an important feature in the treatment of osteoarthritis (OA). The hypothesis of this study was that bone morphology would be different in varus and valgus deformity, both before osteoarthritis development as well as during and after the disease process of OA. MATERIALS AND METHODS: Retrospective study with measurements on preoperative and postoperative full leg standing radiographs of 96 patients who underwent TKA...
January 21, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28103870/osteochondral-autograft-transplantation-with-biplanar-distal-tibial-osteotomy-for-patients-with-concomitant-large-osteochondral-lesion-of-the-talus-and-varus-ankle-malalignment
#17
Xingchen Li, Yuan Zhu, Yang Xu, Bibo Wang, Jinhao Liu, Xiangyang Xu
BACKGROUND: Osteochondral lesions of the talus (OLTs) are amongst the most common foot and ankle disorders. Varus ankle malalignment causes stress concentration on medial side of the joint, resulting in OLTs and osteoarthritis. For large symptomatic OLTs (>10 mm), Osteochondral autograft transplantation is usually recommended. This article highlights biplanar distal tibial osteotomy as an approach and management for patients with concomitant large OLTs and varus ankle malalignment...
January 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28053258/ankle-joint-pressure-changes-in-high-tibial-and-distal-femoral-osteotomies-a-cadaver-study
#18
F Krause, A Barandun, G Klammer, I Zderic, B Gueorguiev, T Schmid
AIMS: To assess the effect of high tibial and distal femoral osteotomies (HTO and DFO) on the pressure characteristics of the ankle joint. MATERIALS AND METHODS: Varus and valgus malalignment of the knee was simulated in human cadaver full-length legs. Testing included four measurements: baseline malalignment, 5° and 10° re-aligning osteotomy, and control baseline malalignment. For HTO, testing was rerun with the subtalar joint fixed. In order to represent half body weight, a 300 N force was applied onto the femoral head...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28017574/correcting-severe-varus-deformity-using-trial-components-during-total-knee-arthroplasty
#19
Man S Kim, In J Koh, Young J Choi, Yong D Kim, Yong In
BACKGROUND: Extensive medial soft tissue release may be necessary to correct severe varus deformity during total knee arthroplasty (TKA). However, this procedure may result in instability. Here, we describe a novel soft tissue balancing technique, which can minimize medial release in severe varus deformity during TKA. METHODS: Fifty knees (40 patients) with hip-knee-ankle angle of more than 20° of varus were corrected using this technique (group 1). After achieving flexion gap balancing by needle puncturing and spreading of the superficial medial collateral ligament, extension gap balancing was obtained by gradual extension with the trial components in place...
December 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27995304/patient-specific-instrumentation-versus-conventional-knee-arthroplasty-comparative-study
#20
Vlad Predescu, Catalin Prescura, Razvan Olaru, Liliana Savin, Paul Botez, Bogdan Deleanu
BACKGROUND: The key to a successful knee replacement is restoring normal kinematics with a neutral alignment, thus a hip-knee-ankle (HKA) angle of 180° (within 3° limits). Conventional TKR is proven to have excellent results but relies in extensive visual referencing of bony landmarks. Customised cutting blocks provide accurate bone cuts, also lowering the risk of fat embolism, blood loss and operating time. METHOD: We share our experience comparing two different TKA techniques using patient specific instrumentation (PSI) with the Visionaire knee and conventional instrumentation (CVI) from the same system (Genesis II Smith&Nephew)...
December 19, 2016: International Orthopaedics
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