How Frequently Do Five Total Arthroplasty Methods Change the Alignment of the Joint Lines and Limb From Normal?

2012 ◽  
Author(s):  
Yu S. Gu ◽  
Joshua D. Roth ◽  
Stephen M. Howell ◽  
Maury L. Hull
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Joint Line ◽  
Coronal Plane ◽  
Mechanical Alignment ◽  
Gap Balancing ◽  
Total Arthroplasty ◽  
Straight Line ◽  
Total Knee

One strategy for aligning the limb and positioning components in total knee arthroplasty (TKA) in the coronal plane is mechanical alignment, which has the goal of positioning the center of the hip, knee, and ankle on a straight-line by establishing a femoral and tibial joint line at the knee that is perpendicular to the mechanical axis of the femur and tibia respectively. Another strategy is gap balancing, which has the goal of creating equal gaps between the medial and lateral compartments at 0° of extension and 90° of flexion.

scholarly journals Bone Cement Solidifiliation Influence the Limb Alignment and Gap Balance during TKA

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Dongquan Shi ◽  
Xingquan Xu ◽  
Anyun Guo ◽  
Jin Dai ◽  
Zhihong Xu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Cement ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Statistical Significance ◽  
Mechanical Alignment ◽  
Early Loosening ◽  
Flexion Extension ◽  
Before And After ◽  
Total Knee

Introduction. Mechanical alignment deviation after total knee arthroplasty is a major reason for early loosening of the prosthesis. Achieving optimum cement penetration during fixation of the femoral and tibial component is an essential step in performing a successful total knee arthroplasty. Bone cement is used to solidify the bone and prosthesis. Thickness imbalance of bone cement leads to the deviation of mechanical alignment. To estimate the influence of bone cement, a retrospective study was conducted.Materials and Methods. A total of 36 subjects were studied. All the TKA were performed following the standard surgical protocol for navigated surgery by medial approach with general anaesthesia. Prostheses were fixed by bone cement.Results. We compared the mechanical axis, flexion/extension, and gap balance before and after cementation. All the factors were different compared with those before and after cementation. Internal rotation was reached with statistical significance (P=0.03).Conclusion. Bone cement can influence the mechanical axis, flexion/extension, and gap balance. It also can prompt us to make a change when poor knee kinematics were detected before cementation.

scholarly journals Systematic Review of Accelerometer Based Navigation in Total Knee Arthroplasty: Improved Alignment, Clinical Results, and Patient Reported Outcomes Compared to Conventional Guides?

2020 ◽  
pp. 1-8
Author(s):  
Stephen T. Duncan ◽  
Stephen T. Duncan ◽  
Cale Jacobs ◽  
Lucian Warth ◽  
Syed K. Mehdi
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Knee Arthroplasty ◽  
Operative Time ◽  
Mechanical Axis ◽  
Mechanical Alignment ◽  
Estimated Blood Loss ◽  
Patient Reported ◽  
Total Knee

Background: There have been significant advancements to restore knee alignment postoperatively in the TKA population. This includes the use of accelerometer-based portable navigation (ABN). ABN can lead to a more precise restoration of the neutral mechanical axis, improve efficiency and potentially decrease early- and long-term complications. The degree with which ABN can achieve this remains unclear. We performed a systematic review to answer this question. Methods: We performed a systematic review in accordance with Cochrane guidelines of controlled studies (prospective and retrospective) in MEDLINE with an emphasis on studies comparing postoperative outcomes such as mechanical axis alignment, operative time, blood loss, complications and clinical outcome scores in total knee arthroplasty patients using ABN versus conventional intramedullary guides. Results: ABN was associated with significantly fewer outliers in hip-knee-ankle alignment (p = 0.0006), femoral component alignment (p < 0.0001). ABN was associated with significantly less estimated blood loss (p = 0.05) and no difference in operative times (p = 0.21). Finally, there was no difference regarding functional outcomes or DVT. Conclusion: ABN more accurately achieves neutral mechanical alignment with a smaller incidence of outliers. There was not an increase in operative time with using ABN and there were reductions in blood loss as well. We conclude that ABN offers the benefit of improved mechanical alignment.

Can total knee arthroplasty restore the correlation between radiographic mechanical axis angle and dynamic coronal plane alignment during gait?

The Knee ◽  
2019 ◽  
Vol 26 (3) ◽  
pp. 586-594 ◽  
Author(s):  
Gabriel Larose ◽  
Alexandre Fuentes ◽  
Frederic Lavoie ◽  
Rachid Aissaoui ◽  
Jacques de Guise ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Coronal Plane ◽  
Total Knee

scholarly journals Difference between Mechanical Alignment in Navigation and Scanogram during Total Knee Arthroplasty

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Rohan Bhimani ◽  
Fardeen Bhimani ◽  
Preeti Singh
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Computer Navigation ◽  
Primary Total Knee Arthroplasty ◽  
P Value ◽  
Mechanical Alignment ◽  
Significant Difference ◽  
Total Knee ◽  
The Mean

Introduction. Malpositioning of the implant results in polyethylene wear and loosing of implant after total knee arthroplasty. Scanogram is often used for measurement of limb alignment. Computer navigation provides real time measurements and thus, the aim is to see any association pre- and postoperatively between coronal alignments measured on scanogram to computer navigation during total knee arthroplasty. Material and Methods. We prospectively gathered data of 200 patients with advanced degenerative symptomatic arthritis, who were consecutively selected for primary total knee arthroplasty with computer navigation. Every patient’s pre- and postoperative scanogram were compared to the intraoperative computer navigation findings. Results. The results show that the preoperative mean mechanical axis on navigation was 10.65° (SD ± 6.95) and on scanogram it was 10.38° (SD ± 6.89). On the other hand, the mean postoperative mechanical axis on navigation was 0.69° (SD ± 0.87) and on scanogram it was 2.73° (SD ± 2.10). Preoperatively, there was no significant difference (p value = 0.46) between the two. However, the postoperative outcomes suggest that there was a noteworthy difference, with no correlation between the mean Hip-Knee Ankle Axis (HKA) and intraoperative mechanical axis (p value <0.0001). Conclusion. Postoperative mechanical alignment values after total knee arthroplasty are lower on navigation than measured on standing full length hip to ankle scanogram.

Kinematically Aligned TKA Aligns the Ankle Joint Line Closer to Those of the Native Ankle than Mechanically Aligned TKA in Bipedal Stance

2019 ◽  
Vol 32 (10) ◽  
pp. 1033-1038
Author(s):  
Jung-Taek Kim ◽  
Jun Han ◽  
Sumin Lim ◽  
Quan Hu Shen ◽  
Ye Yeon Won
Keyword(s):  
Total Knee Arthroplasty ◽  
Ankle Joint ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Joint Line ◽  
Control Group ◽  
Talar Dome ◽  
Bipedal Stance ◽  
Ankle Joints ◽  
Total Knee

AbstractMechanically aligned total knee arthroplasty (MATKA) aims to make alignment of the hip, knee, and ankle straight unexceptionally. However, emerging evidence suggests that unexceptional straightening the mechanical axis of the lower limb may lead to clinical and radiological problems of the ankle joint. By contrast, kinematically aligned total knee arthroplasty (KATKA) strives to restore the articular surface of the prearthritic knee. In this study, we examined results from KATKA and MATKA to determine which surgery restores the ankle joint orientation closer to the native ankle joint in bipedal stance and hypothesized that KATKA, rather than MATKA, would be more effective. Data from long-leg standing radiographs of 60 healthy adults (control group, n = 120 knees), patients who underwent MATKA (n = 90 knees), and patients who underwent KATKA (n = 90 knees) were retrospectively reviewed. The hip–knee–ankle angle, orientation of the tibial plafond and the talar dome relative to the ground (G-plafond and G-talus, respectively), and orientation of the plafond relative to the mechanical axis of the limb (M-plafond and M-talus, respectively) were measured and analyzed for comparison. Results show that bipedal stance alignment in patients who underwent KATKA (G-plafond: −0.65 ± 3.03 and G-talus: −1.72 ± 4.02) were not significantly different to native ankle joint alignment indicated by the control group. Compared with the native ankle joint measured in the control group (G-plafond: −0.76 ± 2.69 and G-talus: −1.30 ± 3.25), the tibial plafond and talar dome significantly tilted laterally relative to the ground in ankle joints after MATKA (G-plafond: −2.32 ± 3.30 and G-talus: −2.97 ± 3.98, p = 0.001 and p = 0.004, respectively). Thus, postoperative ankle joint line orientation after KATKA was horizontal to the floor and closer to that of native ankle joints than those after MATKA. The level of evidence is Level III.

Medial stabilizing technique preserves anatomical joint line and increases range of motion compared with the gap-balancing technique in navigated total knee arthroplasty

The Knee ◽  
2020 ◽  
Vol 27 (2) ◽  
pp. 558-564
Author(s):  
Kyota Ishibashi ◽  
Eiji Sasaki ◽  
Shizuka Sasaki ◽  
Yuka Kimura ◽  
Yuji Yamamoto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Joint Line ◽  
Gap Balancing ◽  
Total Knee

Accelerometer-Based Navigation Is as Accurate as Optical Computer Navigation in Restoring the Joint Line and Mechanical Axis After Total Knee Arthroplasty

2016 ◽  
Vol 31 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Graham Seow-Hng Goh ◽  
Ming Han Lincoln Liow ◽  
Winston Shang-Rong Lim ◽  
Darren Keng-Jin Tay ◽  
Seng Jin Yeo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Computer Navigation ◽  
Joint Line ◽  
Total Knee ◽  
Optical Computer

Robot-Assisted Total Knee Arthroplasty Accurately Restores the Joint Line and Mechanical Axis. A Prospective Randomised Study

2014 ◽  
Vol 29 (12) ◽  
pp. 2373-2377 ◽  
Author(s):  
Ming Han Lincoln Liow ◽  
Zhan Xia ◽  
Merng Koon Wong ◽  
Keng Jin Tay ◽  
Seng Jin Yeo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Joint Line ◽  
Robot Assisted ◽  
Randomised Study ◽  
Total Knee ◽  
Prospective Randomised Study
Sign in / Sign up

Export Citation Format

Share Document