scholarly journals A Perspective on Robotic Assistance for Knee Arthroplasty

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Nathan A. Netravali ◽  
Feimo Shen ◽  
Youngbae Park ◽  
William L. Bargar
Keyword(s):  
Surgical Technique ◽  
Knee Arthroplasty ◽  
Clinical Results ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Implant Design ◽  
Robotic Assistance ◽  
Surgical Assistance ◽  
Number Of Patients ◽  
Assistance Systems

Knee arthroplasty is used to treat patients with degenerative joint disease of the knee to reduce pain and restore the function of the joint. Although patient outcomes are generally quite good, there are still a number of patients that are dissatisfied with their procedures. Aside from implant design which has largely become standard, surgical technique is one of the main factors that determine clinical results. Therefore, a lot of effort has gone into improving surgical technique including the use of computer-aided surgery. The latest generation of orthopedic surgical tools involves the use of robotics to enhance the surgeons’ abilities to install implants more precisely and consistently. This review presents an evolution of robot-assisted surgical systems for knee replacement with an emphasis on the clinical results available in the literature. Ever since various robotic-assistance systems were developed and used clinically worldwide, studies have demonstrated that these systems are as safe as and more accurate than conventional methods of manual implantation. Robotic surgical assistance will likely result in improved surgical technique and improved clinical results.

scholarly journals Periprosthetic fractures of the knee: a comprehensive review

2019 ◽  
Vol 30 (3) ◽  
pp. 387-399 ◽  
Author(s):  
Vadim Benkovich ◽  
Yuri Klassov ◽  
Boris Mazilis ◽  
Shlomo Bloom
Keyword(s):  
Knee Arthroplasty ◽  
Rare Complication ◽  
Treatment Options ◽  
Degenerative Joint Disease ◽  
Joint Arthroplasty ◽  
Joint Disease ◽  
Periprosthetic Fractures ◽  
Complex Injury ◽  
Life Threatening ◽  
Total Knee

AbstractDemographic changes have resulted in an increase in the number of older patients diagnosed with degenerative joint disease. Developments in the field of joint arthroplasty allow a broader population to improve their lifestyles. An increased demand for knee arthroplasty has led to a rise in operations performed worldwide. Although there has been a constant propagation of technology and an increase in medical staffing at a professional level, many patients still encounter complications. Though rare, these factors may lead to life-threatening scenarios and a devastating effect on the success of the operation. One such rare complication includes periprosthetic fractures around the knee, a complex injury which requires a cautious and experienced approach. In this review, we analyze the prevalence, risk factors and classification, investigation and treatment options for periprosthetic fractures with total knee arthroplasty.

Avulsion Fractures of the Femoral Head: Internal Fixation Using a Ventral Approach to the Hip Joint

1997 ◽  
Vol 10 (01) ◽  
pp. 23-26 ◽  
Author(s):  
P. M. Montavon ◽  
H. F. L’Eplattenier
Keyword(s):  
Femoral Head ◽  
Surgical Technique ◽  
Hip Joint ◽  
Cartilage Damage ◽  
Kirschner Wire ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Joint Surface ◽  
Avulsion Fractures ◽  
Lag Screw

SummaryAvulsion fractures of the femoral head are encountered in conjunction with craniodorsal luxations of the hip joint and cannot be treated conservatively without risking either reluxation of the joint or considerable cartilage damage resulting in degenerative joint disease. Fixation of the fragment is possible by inserting a Kirschner wire and a lag screw from the articular surface, making sure the implants are well countersunk. A ventromedial approach to the hip joint allows good visibility of the joint surface and easy reduction of the fracture without severing the round ligament. The surgical technique described was used on three cases and combines a ventromedial approach to the hip joint with fixation of the fracture with a Kirschner wire and a lag screw inserted from the joint surface, and has the advantages of enabling good reconstruction of the joint surface as well as maintaining postoperative joint stability. Both these factors considerably reduce the development of degenerative joint disease and improve the prognosis for recovery of full limb function.A surgical technique for treatment of avulsion fractures of the femoral head is described. It combines a ventromedial approach to the hip joint with fixation of the fracture with a Kirschner wire and a lag screw inserted from the joint surface.

scholarly journals PROFIL PENDERITA OSTEOARTRITIS LUTUT DENGAN OBESITAS DI INSTALASI REHABILITASI MEDIK BLU RSUP PROF. DR. R. D KANDOU MANADO

e-CliniC ◽  
2014 ◽  
Vol 2 (3) ◽  
Author(s):  
William Kusuma ◽  
Engeline Angliadi ◽  
L. S. Angliadi
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Medical Record ◽  
Developed Countries ◽  
Degenerative Joint Disease ◽  
Overweight And Obesity ◽  
Joint Disease ◽  
Osteoarthritis Of The Knee ◽  
Keywords Knee ◽  
Number Of Patients

Abstract: osteoarthritis is derived from greek meaning bone, arthro meaning joint and itis meaning inflammation. Osteoarthritis is a degenerative joint disease that is chronic,progessive runing slow, often inflamed or causes only mild inflammation, and characterized by deterioration and abrasion of articular cartilage as well as by two risk factor are: risk factors that cannot be changed and modifable risk factors. Obesity is a global epidemic in developed countries and developing countries such as Indonesia, particularly in urban strip. This situation is caused by unbalanced energy intake with energy expenditure and excess energy is stored as body fat within a specified period. Objectives: this study aimed to determine the role of risk factor of obesity on the incidence of osteoarthitis of the knee in patients who visit the Rehabilitation Medical Installation BLU Prof. DR. R. D. Kandou Manado. Method: this type of research is descriptive research by taking medical record in medical rehabillitation installation at BLU RSUP Prof. DR. R. D. Kandou Manado. Result: in this study was obtained from descriptive data/medical record(MR) found the number of patients diagnosed with osteoarthritis of the knee by 74 people. Obtained as many as 31 people who have data(weight and height),3 complete lack data because just have weight and 40 people don’t have either weight or height. Research results knee OA patient who come control in the installation of medical rehabillitation only 31are listed the data Body Mass Indeks(weight and height), there are 5 people who have normal BMI, and 26 people who had a BMI of both overweight and obesity excess. Conclusion: from here we may see one of the risk factor for OA knee is obesity Keywords: Knee osteoarthritis, obesity.     Abstrak: Osteoartritis (OA) berasal dari bahasa Yunani yaitu osteo yang berarti tulang, arthro yang berarti sendi dan itis yang berarti inflamasi. Osteoartritis adalah penyakit degeneratif sendi yang bersifat kronik,  berjalan progresif lambat, seringkali tidak meradang atau hanya menyebabkan inflamasi ringan, dan ditandai dengan adanya deteriorasi dan abrasi rawan sendi serta  oleh 2 faktor resiko yaitu: faktor resiko yang tidak dapat diubah dan faktor resiko yang dapat diubah. Obesitas merupakan epidemi global pada negara-negara maju dan negara berkembang seperti di Indonesia,  terutama di daerah perkotaan. Keadaan ini diakibatkan  karena pemasukan energi tidak seimbang dengan pengeluaran energi dan kelebihan energi ini disimpan dalam bentuk lemak tubuh dalam jangka waktu tertentu. Tujuan: Penelitian ini bertujuan untuk mengetahui peranan faktor resiko obesitas terhadap angka kejadian osteoartritis lutut pada penderita yang berkunjung di Instalasi Rehabilitasi Medik BLU RSUP Prof. DR. R. D. Kandou Manado. Metode: Jenis penelitian ini adalah penelitian deskriptif dengan mengambil data rekam medik di Instalasi Rehabilitasi Medik BLU RSUP Prof. DR. R. D. Kandou Manado.  Hasil: Pada penelitian yang didapatkan dari data deskriptif/rekam medik (RM) didapatkan jumlah penderita yang didiagnosis dengan osteoartritis lutut sebanyak 74 orang. Didapatkan sebanyak 31 orang yang memiliki data BB dan TB, 3 data kurang lengkap yaitu hanya terdapat data BB dan 40 data yang tidak mempunyai baik BB maupun TB. Hasil penelitian menyatakan penderita OA lutut yang datang kontrol di Instalasi Rehabilitasi Medik,hanya 31 yang tercantum data IMT (BB&TB),terdapat 5 orang yang memiliki IMT normal,dan 26 orang yang memiliki IMT berlebih baik overweight maupun obesitas. Simpulan: Dari sini kita bisa melihat salah satu faktor resiko OA lutut adalah obesitas. Kata Kunci: Osteoartritis lutut, Obesitas.

scholarly journals The Levels of Depression, Anxiety and Stress on Pre and Post Knee Arthroplasty Patients

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Ardilla Hanim Abdul Razak ◽  
Ahmad Hafiz Zulkifly ◽  
Ramli Musa ◽  
Mohd Shukrimi Awang ◽  
Kian Liang Goh
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Psychological Impact ◽  
Well Being ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Major Advance ◽  
Mouth Dryness ◽  
Primary Indication ◽  
Total Knee

Introduction: Total knee arthroplasty represents a major advance in the treatment of degenerative joint disease. It provides excellent restoration of joint function and pain relief. The primary indication for total knee arthroplasty is to relieve pain caused by severe arthritis, with or without significant deformity. This study is to assess psychological impact pre and post arthroplasty. Materials and method: A prospective study on a cohort of patients from June 2010 untill December 2011 admitted to Hospital Tengku Ampuan Afzan for total knee replacement. Cognition tested using DASS21 (Depression Anxiety Stress Scales 21). Questionnaires were distributed 2 days before the operation and 6 months after the operation during clinic follow up. Verbal consent acquired from the patients before giving the questionnaires. Sets of questions are self-administered. Results: As for DASS 21 analysis, pre and post-operative depression was 19.91±4.92 and 6.42±3.64 respectively. Moderate depression became normal post-operative. Questions regarding positive feeling, courage to do things, hope, self- appreciation and the meaning of life were asked pre and post operatively. Pre-operative anxiety was 19.49±4.92 and post-operative anxieties at 6 months were 6.42±3.64. Severe anxiety became normal after 6 months. Patients were asked about mouth dryness, difficulty in breathing on resting, tremor, panicking and unnecessary anxiety pre and post operatively. Post-operative stress improved tremendously from 22.47±4.27 down to 8.56±3.42. Conclusion: As a conclusion, total knee arthroplasty is well accepted in Malaysia. It improves patients’ social and emotional well-being. With the current advancement in total knee arthroplasty, surgeons not only looking into the post-operative physical function, they also look after the cognitive function as the outcome measure of total knee arthroplasty.

scholarly journals Hindfoot Arthrodesis using the Medial Approach to Correct Adult Acquired Valgus Flat Feet: A Series of Cases

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0020
Author(s):  
Gabriel F. Ferraz ◽  
Miguel V. Pereira Filho ◽  
Daniel Oksman
Keyword(s):  
Wound Dehiscence ◽  
Clinical Results ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Visual Analogue Pain Scale ◽  
Superficial Infection ◽  
Medial Approach ◽  
Visual Analogue Pain ◽  
Flat Feet ◽  
Hindfoot Arthrodesis

Category: Hindfoot Introduction/Purpose: Hindfoot arthrodesis is used in patients with flat feet acquired in advanced stages, usually associated with degenerative joint disease. The objective of the study is to evaluate the clinical and radiographic results of hindfoot arthrodesis using the medial approach. Methods: A prospective cohort of 23 consecutive patients who underwent surgical correction between the years 2012 and 2018 through the hindfoot modeling arthrodesis was evaluated. Clinical assessment was performed using the visual analogue pain scale (VAS), AOFAS score for the hindfoot, SF-36 and FFI (Foot Function Index). Radiographic images were also analyzed, as well as satisfaction criteria. Results: In six procedures, calcanecuboid arthrodesis was included, with a small lateral access route. The average pain score decreased by 6.04 points (p <0.001), with an average final AOFAS of 75.63. Two cases presented talus necrosis, in three there was no consolidation of talonavicular arthrodesis, and in three others, synthesis material was removed. No case presented wound dehiscence and only one needed to treat superficial infection with antibiotics. Conclusion: Arthrodesis to correct adult acquired valgus flat feet can be performed using the medial approach with good clinical results and low rates of healing complications. However, about 25% of the patients had other complications that led to the need for a surgical approach.

scholarly journals Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature

Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 225
Author(s):  
Marcin Derwich ◽  
Maria Mitus-Kenig ◽  
Elzbieta Pawlowska
Keyword(s):  
Temporomandibular Joint ◽  
Dental Treatment ◽  
Clinical Symptoms ◽  
Interdisciplinary Approach ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Treatment Modalities ◽  
Age Related ◽  
Number Of Patients ◽  
Temporomandibular Joint Osteoarthritis

Background and objectives: There is an increasing number of patients applying for dental treatment who suffer from temporomandibular joint osteoarthritis (TMJOA). Osteoarthritis may be the cause of the pain in the area of temporomandibular joints, but its course may also be absolutely asymptomatic. The aim of this study was to present an interdisciplinary approach to TMJOA, including current diagnostics and treatment modalities on the basis of the available literature. Materials and Methods: PubMed and Scopus databases were analyzed using the keywords: ((temporomandibular joint AND osteoarthritis) AND imaging) and ((temporomandibular joint AND osteoarthritis) AND treatment). The bibliography was supplemented with books related to the temporomandibular joint. After screening 2450 results, the work was based in total on 98 publications. Results and Conclusions: Osteoarthritis is an inflammatory, age-related, chronic and progressive degenerative joint disease. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT), together with clinical symptoms, play significant roles in TMJOA diagnosis. Current MRI techniques seem to be clinically useful for assessment of bony changes in temporomandibular joint (TMJ) disorders. Treatment of TMJOA requires a complex, interdisciplinary approach. TMJOA treatment includes the cooperation of physiotherapists, rheumatologists, gnathologists, orthodontists and quite often also maxillofacial surgeons and prosthodontists. Sometimes additional pharmacotherapy is indicated. Thorough examination of TMJ function and morphology is necessary at the beginning of any orthodontic or dental treatment. Undiagnosed TMJ dysfunction may cause further problems with the entire masticatory system, including joints, muscles and teeth.

scholarly journals A new lesser metatarsophalangeal joint replacement arthroplasty design - in vitro and cadaver studies

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Nikiforos P. Saragas ◽  
Paulo N. F. Ferrao ◽  
Andrew Strydom
Keyword(s):  
Surgical Technique ◽  
Range Of Motion ◽  
Joint Replacement ◽  
Metatarsophalangeal Joint ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Replacement Arthroplasty ◽  
Cadaver Studies ◽  
Freiberg’S Infraction

Abstract Background Isolated degenerative joint disease and/or Freiberg’s infraction of the lesser metatarsophalangeal joint, although not frequent may become debilitating in the younger individual. Currently, once conservative management fails, the mainstay of treatment is debridement and excision-interposition arthroplasty. Replacement arthroplasty has been ineffective in the long term as the joints are subject to severe repetitive fatigue loading over small articulating surfaces through a wide range of motion. This is an in vitro and cadaver study of a new design replacement arthroplasty developed by the senior author. The aim of this study is to evaluate this novel replacement arthroplasty of the lesser metatarsophalangeal joint in a laboratory setting and cadaver implantation. Methods This three-component mobile bearing device is made of titanium and high density polyethylene which evolved over 4 years. It was subjected to 5,000,000 cycles in a laboratory under physiological and excessive forces to assess resistance to fatigue failure and wear pattern of the polyethylene liner. Following these tests, it was implanted in 15 fresh frozen cadavers at various stages of its development, during which the surgical technique was perfected. Range of motion and stability was tested using custom made instrumentation in four cadavers. The implant was inserted in a further two cadavers by an independent foot and ankle surgeon to check reproducibility. Results The device showed almost no signs of wear or surface deformation under physiological forces. The surgical technique was found to be simple and reproducible in the cadaver trial. The average dorsiflexion was 28.5° and 28.9° pre- and post-implant respectively. The average plantar flexion was 33.8° and 20.8° pre- and post- implant respectively. The joints were stable both pre- and post-operatively. Post-operative stability was objectively assessed for dorsal displacement and dorsiflexion using a 5 kgf (49 N) and was found to be excellent. Conclusion This novel lesser metatarsophalangeal joint replacement arthroplasty has been developed as an option in the surgical treatment of symptomatic degenerative joint disease and/or Freiberg’s infraction resistant to conservative treatment. The implant was found to be durable and resistant to wear in the laboratory testing. The cadaver studies have shown it to require minimal specialized instrumentation with good surgical reproducibility. This proof of concept study is the basis for clinical trials.

scholarly journals Sensor guided unicompartmental to total knee arthroplasty revision: Surgical technique

2021 ◽  
Vol 12 (4) ◽  
Author(s):  
Pier Francesco Indelli ◽  
Salvatore Risitano ◽  
Gennaro Pipino ◽  
Stefano Ghirardelli ◽  
Bruno Violante
Keyword(s):  
Total Knee Arthroplasty ◽  
Surgical Technique ◽  
Aseptic Loosening ◽  
Knee Arthroplasty ◽  
Polyethylene Wear ◽  
The United States ◽  
Implant Design ◽  
Unicompartmental Knee ◽  
Sensing Technology ◽  
Total Knee

Unicompartmental Knee Arthroplasty (UKA) is an effective surgical option for managing unicompartmental knee osteoarthritis; it represents 10% of all knee arthroplasties worldwide, increasing 32.5% annually in the United States alone. Despite evolution in surgical technique and implant design, success rate and long-term survivorship of UKA have been historically lower than Total Knee Arthroplasty (TKA). The most common causes of UKA failure leading to revision are polyethylene wear, progression of arthritis, aseptic loosening and patella-femoral symptoms due to poor patient selection in many cases. Historically, UKA revisions have presented technical challenges mainly related to managing residual bone defects and ligament insufficiency ultimately leading to knee instability: the fear of instability has often pushed surgeons to lower the threshold for an increase of the intra-articular level of constraint. Unfortunately, the use of more constrained implants requires sacrificing bone stock and has been related to higher rates of re-revision secondary to recurrence of aseptic loosening. Because of these challenges, the authors developed a surgical technique that could combine balancing the knee during revision surgery with the use of the less constrained polyethylene option. To achieve this, we started evaluating a novel device (VERASENSE, Orthosensor, FL) designed to support soft tissue balancing during primary TKA. This intraoperative sensing technology dynamically quantifies intra-articular loads during TKA trial with the goal of correcting any residual imbalance in real time. Herein we propose a novel surgical technique, which might allow use of a primary TKA design characterized by a lower level of constraint, instead of a constrained or hinged revision knee system, during UKA revision. A key aspect of this technique is the use of sensing technology during intraoperative stability testing.

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