Assessment of a Medial Pivot Total Knee Arthroplasty Design in a Cadaveric Knee Extension Test Model

2012 ◽  
Vol 27 (8) ◽  
pp. 1460-1468.e1 ◽  
Author(s):  
C. Lowry Barnes ◽  
J. David Blaha ◽  
David DeBoer ◽  
Paul Stemniski ◽  
Richard Obert ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Extension ◽  
Test Model ◽  
Medial Pivot ◽  
Total Knee ◽  
Total Knee Arthroplasty Design ◽  
Cadaveric Knee

scholarly journals Over-constrained kinematic of the medial compartment leads to lower clinical outcomes after total knee arthroplasty

2021 ◽  
Author(s):  
Nicola Pizza ◽  
Stefano Di Paolo ◽  
Raffaele Zinno ◽  
Giulio Maria Marcheggiani Muccioli ◽  
Piero Agostinone ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Motor Task ◽  
Medial Compartment ◽  
Level Of Evidence ◽  
Contact Points ◽  
Sit To Stand ◽  
Medial Pivot ◽  
Total Knee

Abstract Purpose To investigate if postoperative clinical outcomes correlate with specific kinematic patterns after total knee arthroplasty (TKA) surgery. The hypothesis was that the group of patients with higher clinical outcomes would have shown postoperative medial pivot kinematics, while the group of patients with lower clinical outcomes would have not. Methods 52 patients undergoing TKA surgery were prospectively evaluated at least a year of follow-up (13.5 ± 6.8 months) through clinical and functional Knee Society Score (KSS), and kinematically through dynamic radiostereometric analysis (RSA) during a sit-to-stand motor task. Patients received posterior-stabilized TKA design. Based on the result of the KSS, patients were divided into two groups: “KSS > 70 group”, patients with a good-to-excellent score (93.1 ± 6.8 points, n = 44); “KSS < 70 group”, patients with a fair-to-poor score (53.3 ± 18.3 points, n = 8). The anteroposterior (AP) low point (lowest femorotibial contact points) translation of medial and lateral femoral compartments was compared through Student’s t test (p < 0.05). Results Low point AP translation of the medial compartment was significantly lower (p < 0.05) than the lateral one in both the KSS > 70 (6.1 mm ± 4.4 mm vs 10.7 mm ± 4.6 mm) and the KSS < 70 groups (2.7 mm ± 3.5 mm vs 11.0 mm ± 5.6 mm). Furthermore, the AP translation of the lateral femoral compartment was not significantly different (p > 0.05) between the two groups, while the AP translation of the medial femoral compartment was significantly higher for the KSS > 70 group (p = 0.0442). Conclusion In the group of patients with a postoperative KSS < 70, the medial compartment translation was almost one-fourth of the lateral one. Surgeons should be aware that an over-constrained kinematic of the medial compartment might lead to lower clinical outcomes. Level of evidence II.

No differences in patient-reported outcomes between medial pivot insert and symmetrical insert in total knee arthroplasty: A randomized analysis

The Knee ◽  
2018 ◽  
Vol 25 (6) ◽  
pp. 1254-1261 ◽  
Author(s):  
Kohei Nishitani ◽  
Moritoshi Furu ◽  
Shinichiro Nakamura ◽  
Shinichi Kuriyama ◽  
Masahiro Ishikawa ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patient Reported Outcomes ◽  
Patient Reported ◽  
Medial Pivot ◽  
Total Knee

scholarly journals Early resumption of driving within 3 weeks following patient-specific instrumented total knee arthroplasty: an evaluation of 160 cases

2019 ◽  
Vol 4 (2) ◽  
pp. 88-92
Author(s):  
Ikram Nizam ◽  
Ashish Batra ◽  
Sophia Gogos
Keyword(s):  
Total Knee Arthroplasty ◽  
Median Time ◽  
Knee Arthroplasty ◽  
Patient Specific ◽  
Level Of Evidence ◽  
The Third ◽  
Ankle Joints ◽  
Medial Pivot ◽  
Total Knee ◽  
Detailed Questionnaire

ObjectivesMost patients want to resume normal activities as soon as possible after total knee arthroplasty (TKA), with driving an integral aspect to re-establish social and recreational independence. This study aimed to determine when patients resumed driving after TKA.MethodsAll patients undergoing patient-specific instrumented (PSI) medial pivot TKA between January 2017 and April 2018 were included. Patients who did not drive were excluded. A detailed questionnaire was sent to patients 2 weeks after surgery to record their driving status. 50 patients were randomly selected to assess flexion at the hip, knee and ankle joints while seated in the driver’s seat of their own vehicle.Results160 patients (female=94 and male=66) with a mean age of 68 years (45–90 years) underwent a PSI TKA (left side [L]=75, right side [R]=85). 73% patients returned to driving within the first 3 weeks after surgery, of which 15 (10%) resumed driving within the first postoperative week, 52 (35%) in the second week and 41 (28%) in the third week. The median time to resume driving following surgery was 3 weeks for both operative sides, with IQR of 2.0 (L) and 1.0 (R).ConclusionA majority of patients resume driving within 3 weeks after undergoing a PSI TKA, regardless of operative side or transmission of vehicle.Level of evidenceIV

Decreasing Posterior Femoral Condyle Offset Improves Intraoperative Correction of Flexion Contracture in Total Knee Arthroplasty

2020 ◽  
Author(s):  
Murilo Anderson Leie ◽  
Antonio Klasan ◽  
Wei Wang Yeo ◽  
Dylan Misso ◽  
Myles Coolican
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femoral Condyle ◽  
Knee Extension ◽  
Flexion Contracture ◽  
Level Of Evidence ◽  
Full Extension ◽  
Time Of Surgery ◽  
Posterior Femoral Condyle ◽  
Total Knee

AbstractMultiple intraoperative strategies are described to achieve full extension in total knee arthroplasty, but only a few studies have assessed the effect of the flexion gap on intraoperative improvement in flexion contracture. The aim of this study was to determine whether posterior condylar offset, in isolation, independently affects extension at the time of total knee arthroplasty.Two hundred and seventy-eight patients who underwent total knee arthroplasty for knee osteoarthritis and flexion contracture ≥ 5 degrees between January 2008 and July 2018 were included in this study. Patients with other factors that could affect knee extension at the time of surgery were excluded. We recorded the thickness of posterior femoral condyle bone resected as well as the thickness of the posterior femoral component chosen for each patient. Patients' knee extension was recorded under anesthetic, prior to resection and intraoperatively after total knee replacement.Average thickness of bone resection for the posteromedial femur was 12.64  ± 1.65 mm and for the posterolateral femur was 10.38  ± 1.52 mm. Using a linear regression model, we found that changes in posterior offset and implant downsizing influenced correction of fixed flexion deformity at the time of surgery. When patients had a combined posteromedial and posterolateral offset 2 mm thinner than the thickness of bone resected, there was an average correction of 3.5 degrees of flexion contracture.Our study demonstrated that posterior femoral condyle offset is an independent variable affecting correction of flexion contracture at the time of surgery in a gap balanced cruciate-retaining total knee arthroplasty. Level of evidence Level IV evidence

An 11- to 15-year clinical outcome study of the Advance Medial Pivot total knee arthroplasty

2016 ◽  
Vol 98-B (8) ◽  
pp. 1050-1055 ◽  
Author(s):  
Th. Karachalios ◽  
S. Varitimidis ◽  
K. Bargiotas ◽  
M. Hantes ◽  
N. Roidis ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcome ◽  
Knee Arthroplasty ◽  
Outcome Study ◽  
Medial Pivot ◽  
Total Knee ◽  
Clinical Outcome Study

Modified Intervastus Approach to the Knee

2017 ◽  
Vol 31 (05) ◽  
pp. 422-424
Author(s):  
James Kohlman ◽  
Craig Valle ◽  
Muthana Sartawi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Extension ◽  
Extensor Mechanism ◽  
Vastus Medialis ◽  
Medial Parapatellar Approach ◽  
Total Knee ◽  
Anterior Knee ◽  
Medial Parapatellar

AbstractThe modified intervastus approach to the anterior knee is an approach that may be used in the majority of patients undergoing total knee arthroplasty. This article presents the first description of this approach. The advantages of this approach include its extensile nature, similar to a medial parapatellar approach, and preservation of the extensor mechanism and the vastus medialis, leading to a more rapid return to active knee extension than is traditionally observed. The approach is also simple to perform, easy to close, and is compatible with more extensile approaches such as a quadriceps snip if required in revision scenarios.

Role of telerehabilitation in patients following total knee arthroplasty: Evidence from a systematic literature review and meta-analysis

2016 ◽  
Vol 23 (2) ◽  
pp. 339-346 ◽  
Author(s):  
H Shukla ◽  
SR Nair ◽  
D Thakker
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Knee Arthroplasty ◽  
Knee Extension ◽  
Control Group ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Total Knee

Introduction Increased physical activity and functional ability are the goals of total knee replacement surgery. Therefore, adequate rehabilitation is required for the recovery of patients after discharge from hospital following total knee arthroplasty (TKA). This systematic literature review aimed to evaluate the effectiveness of home telerehabilitation in patients who underwent TKA. Methods Studies published in the English language between 2000 and 2014 were retrieved from Embase, PubMed, and Cochrane databases using relevant search strategies. Two researchers independently reviewed the studies as per the Cochrane methodology for systematic literature review. We considered telerehabilitation sessions as those that were conducted by experienced physiotherapists, using videoconferencing to patients’ homes via an internet connection. The outcomes assessed included: knee movement (knee extension and flexion); quadriceps muscle strength; functional assessment (the timed up-and-go test); and assessment of pain, stiffness, and functional capacity using the Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale for pain. Results In total, 160 potentially relevant studies were screened. Following the screening of studies as abstracts and full-text publications, six primary publications (four randomized controlled trials, one non-randomized controlled trial, and one single-arm trial) were included in the review. Patients experienced high levels of satisfaction with the use of telerehabilitation alone. There was no significant difference in change in active knee extension and flexion in the home telerehabilitation group as compared to the control group (mean difference (MD) −0.52, 95% CI −1.39 to 0.35, p = 0.24 and MD 1.14, 95% CI −0.61 to 2.89, p = 0.20, respectively). The patients in the home telerehabilitation group showed improvement in physical activity and functional status similar to patients in the conventional therapy group. Discussion The evidence from this systematic literature review demonstrated that telerehabilitation is a practical alternative to conventional face-to-face rehabilitation therapy in patients who underwent TKA.

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