scholarly journals Standard Cruciate-Retaining Total Knee Arthroplasy Implants Can Reproduce Native Kinematics

10.29007/lj2j ◽  
2020 ◽  
Author(s):  
David Leandro Dejtiar ◽  
Laura Bartsoen ◽  
Mariska Wesseling ◽  
Roel Wirix-Speetjens ◽  
Jos Vander Sloten ◽  
...  
Keyword(s):  
Knee Kinematics ◽  
Musculoskeletal Model ◽  
Common Procedure ◽  
Cruciate Retaining ◽  
Patient Reported ◽  
Operative Planning ◽  
Quality Of Movement ◽  
Total Knee ◽  
Tibiofemoral Kinematics

Total knee arthroplasty (TKA) is a common procedure that has become the standard of treatment for severe cases of knee osteoarthritis. Biomechanics and quality of movement similar to healthy were found to improve patient-reported outcomes.In this study, an evaluated musculoskeletal model predicted ligament, contact and muscle forces together with secondary tibiofemoral kinematics. An artificial neural network applied to the musculoskeletal model searched for the optimal implant position in a given range that will minimize the root-mean-square-error (RMSE) between post- TKA and native experimental tibiofemoral kinematics during a squat.We found that, using a cruciate-retaining implant, native kinematics could be accurately reproduced (average RMSE 1.47 mm (± 0.89 mm) for translations and 2.89° (± 2.83°) for rotations between native and optimal TKA alignment). The required implant positions changes maximally 2.96 mm and 2.40o. This suggests that when using pre- operative planning, off-the-shelf CR implants allow for reproducing native knee kinematics post-operatively.

Robotics in Total Knee Arthroplasty

2019 ◽  
Vol 32 (07) ◽  
pp. 600-606 ◽  
Author(s):  
Maria Bautista ◽  
Jorge Manrique ◽  
William J. Hozack
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Objective Assessment ◽  
Survival Function ◽  
Knee Kinematics ◽  
Successful Operation ◽  
Advantages And Disadvantages ◽  
Patient Reported ◽  
Total Knee

AbstractTotal knee arthroplasty (TKA) is a highly successful operation that improves patients' quality of life and functionality. Yet, up to 20% of TKA patients remain unsatisfied with their clinical result. Robotic TKA has gained increased attention and popularity as a means of improving patient satisfaction. The promise of robotic-assisted TKA is that it provides a surgeon with a tool that accurately executes bone cuts according to presurgical planning, as well as provides the surgeon with intraoperative feedback helpful for restoring knee kinematics and soft tissue balance. Several systems are now available, each with their own advantages and disadvantages. Evidence that the use of robotics will lead to improved implant survival, function, and patient-reported outcomes is slowly being accumulated, but this has not been clearly proven to date. Recent literature does show that the use of robotics during TKA is not associated with increased surgical time or complications. The goal of this review is to provide an objective assessment of the evidence surrounding robotic technology for TKA.

Polyethylene Components in Primary Total Knee Arthroplasty: A Comprehensive Overview of Fixed Bearing Design Options

2021 ◽  
Author(s):  
Cynthia A. Kahlenberg ◽  
Brian Chalmers ◽  
Hyung Jin Sun ◽  
David J. Mayman ◽  
Geoffrey H. Westrich ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
Primary Total Knee Arthroplasty ◽  
Polyethylene Insert ◽  
Specific Patient ◽  
Cruciate Retaining ◽  
Persistent Symptoms ◽  
Patient Reported ◽  
Total Knee

AbstractThe articular design of a polyethylene insert influences the kinematics and overall function of a total knee arthroplasty (TKA). Standard symmetric posterior-stabilized and cruciate-retaining polyethylene designs have a long track record of high patient satisfaction and longevity in TKA. However, the number and variety of polyethylene inserts and articulations have continued to evolve in an attempt to better replicate native knee kinematics or provide additional constraint. Ultracongruent polyethylene designs have been touted as increasing stability while maintaining the benefits of cruciate-retaining knees. Medial pivot and lateral/dual pivot polyethylene designs were introduced to mimic more normal knee kinematics with regard to femoral rollback. Further, with increasing recognition of knee instability as a cause for persistent symptoms and revision TKA, the utilization of midlevel constraint polyethylene inserts has been increasing, with multiple implant companies offering an insert design with increased constraint for use with a primary femoral component. In this rapidly evolving arena in with a myriad of options available, surgeons should be knowledgeable about the design concepts and their applicable uses for specific patient scenarios. Future research is needed to better understand whether a particular type or design of polyethylene insert and articulation leads to improved patient reported outcomes, improved replication of knee kinematics, and long-term durable implant survivorship.

scholarly journals Outcomes of the rotating hinge knee in revision total knee arthroplasty with a median follow-up of 6.2 years

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jake von Hintze ◽  
Mika Niemeläinen ◽  
Harri Sintonen ◽  
Jyrki Nieminen ◽  
Antti Eskelinen
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Survival Rate ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Patient Reported ◽  
Total Knee ◽  
Revision Tka

Abstract Background The purpose of this study was to determine the mid-term clinical, radiographic and health-related quality of life (HRQoL) outcomes and define the survival rate in patients who had undergone revision total knee arthroplasty (TKA) using the single rotating hinged knee (RHK) design. Methods Between January 2004 and December 2013, 125 revision TKAs were performed at our institution using the single RHK implant. We conducted both a retrospective analysis of prospectively collected outcome data of these patients and a prospective follow-up study of all 39 living patients (41 knees). The follow-up phase included an optional extra follow-up visit, PROM questionnaires, and plain radiographs. Results The ten-year Kaplan-Meier survival rate of the revision RHK knees was 81.7% (95% CI 71.9–91.6%) with re-revision for any reason as the endpoint. Overall, 15 knees (12% of the total) underwent re-revision surgery during the follow-up. The median follow-up was 6.2 years (range, 0–12.7 years) post-operatively for the baseline group. One mechanical hinge mechanism-related failure occurred without any history of trauma or infection. At the time of the final follow-up, the majority of patients evinced a fairly good clinical outcome measured with patient-reported outcome measures and none of the components were radiographically loose. Conclusion We found that in patients undergoing complex revision TKA, fairly good functional outcome and quality of life can be achieved using an RHK implant. Further, it seems that in this type of patient cohort, revision TKA using an RHK implant relieves pain more than it improves ability to function. The NexGen® RHK design can be regarded as a suitable option in complex revision TKA.

scholarly journals Three-year clinical and radiological results of a cruciate-retaining type of the knee prosthesis with anatomical geometry developed in Japan

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Arata Nakajima ◽  
Manabu Yamada ◽  
Masato Sonobe ◽  
Yorikazu Akatsu ◽  
Masahiko Saito ◽  
...  
Keyword(s):  
Knee Prosthesis ◽  
Cruciate Retaining ◽  
Radiolucent Lines ◽  
Radiographic Outcomes ◽  
Patient Reported ◽  
Long Term Follow Up ◽  
Total Knee ◽  
Clinical And Radiological Results ◽  
Anatomical Geometry

Abstract Background The FINE total knee was developed in Japan and clinical use began in 2001. It has unique design features, including an oblique 3o femorotibial joint line that reproduces anatomical geometry. Although 20 years have passed since the FINE knee was clinically used for the first time in Japan, a formal clinical evaluation including patient-reported and radiographic outcomes has not been undertaken. Methods A total of 175 consecutive primary cruciate-retaining (CR)-FINE total knee arthroplasties (TKAs) at our hospital between February 2015 and March 2017 were included in this study. Three years postoperatively, range of motion (ROM), Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Forgotten Joint Score (FJS) were recorded and compared with preoperative scores. Radiographic analyses including mechanical alignment, component alignment, and incidence of radiolucent lines also were undertaken based on the radiographs 3 years postoperatively. Results One-hundred twenty-two knees (70%) were available for 3-year follow-up data using KOOS, except for the sports subscale. Postoperative KOOS-symptom, −pain and -ADL were > 85 points, but KOOS-sports, −QOL and FJS were less satisfactory. ROM, KSS and all the subscales of KOOS were significantly improved compared with preoperative scores. Postoperative mean FJS was 66 and was significantly correlated with all the subscales of KOOS, but not with postoperative ROM. Radiolucent lines ≧1 mm wide were detected in five knees (4.1%). There were no major complications needing revision surgeries. Conclusions Patient-reported outcomes (PROs) for symptoms, pain and ADL after the CR-FINE TKA were generally improved, but those for sports, QOL and FJS were improved less. The incidence of radiolucent lines was rare but detected around the femoral components. With the mid- to long-term follow-up, improvements of surgical technique will be necessary to achieve better PROs from patients receiving the FINE knee.

In Vivo Comparison of Knee Kinematics Before and After High-Flexion Posterior Cruciate-Retaining Total Knee Arthroplasty

2010 ◽  
Vol 25 (6) ◽  
pp. 964-969 ◽  
Author(s):  
Atsushi Kitagawa ◽  
Nobuhiro Tsumura ◽  
Takaaki Chin ◽  
Kazuyoshi Gamada ◽  
Scott A. Banks ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
Cruciate Retaining ◽  
High Flexion ◽  
Before And After ◽  
Total Knee

scholarly journals Patient-Reported Outcomes Following Total Knee Replacement in Patients <65 Years of Age—A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (10) ◽  
pp. 3150
Author(s):  
Jason Trieu ◽  
Daniel J. Gould ◽  
Chris Schilling ◽  
Tim Spelman ◽  
Michelle M. Dowsey ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Patient Reported Outcomes ◽  
Meta Analysis ◽  
Functional Decline ◽  
Older Individuals ◽  
Patient Reported ◽  
Related Quality ◽  
Total Knee

An increasing number of total knee replacements (TKRs) are being performed in response to the growing burden of osteoarthritis. Patients <65 years of age represent the fastest growing group of TKR recipients and are expected to account for an increasing number of primary and revision procedures. Concerns have been raised about the outcomes that can be expected by this age demographic who are more active, physically demanding, and have longer life expectancies compared to older TKR recipients. This systematic review and meta-analysis evaluated the effectiveness of TKR for osteoarthritis in patients <65 years of age, compared to older individuals. A systematic search of Embase and Medline was conducted to identify studies which examined patient-reported outcomes measured using disease-specific and generic health-related quality of life instruments. Ten studies met our inclusion criteria and were included in this review. These studies comprised 1747 TKRs performed between 1977 and 2014. In the meta-analysis of two prospective studies (288 TKRs), patients <65 years of age were able to attain large and clinically meaningful improvements in pain, function, and quality of life. One of these studies (61 TKRs) suggested that patients <55 years of age attained a larger degree of improvement compared to older individuals. Results into the second postoperative decade were less certain, with some data suggesting a high prevalence of pain and patterns of functional decline. Further research is required to investigate longer-term outcomes following TKR for osteoarthritis in younger patients.

Knee kinematics after cruciate retaining highly congruent mobile bearing total knee arthroplasty: An in vivo dynamic RSA study

The Knee ◽  
2020 ◽  
Vol 27 (2) ◽  
pp. 341-347 ◽  
Author(s):  
Umberto Cardinale ◽  
Laura Bragonzoni ◽  
Marco Bontempi ◽  
Domenico Alesi ◽  
Tommaso Roberti di Sarsina ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
Mobile Bearing ◽  
Cruciate Retaining ◽  
Total Knee

scholarly journals Predicting clinical outcomes after total knee arthroplasty from preoperative radiographic factors of the knee osteoarthritis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kaoru Toguchi ◽  
Arata Nakajima ◽  
Yorikazu Akatsu ◽  
Masato Sonobe ◽  
Manabu Yamada ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patient Reported Outcomes ◽  
Knee Injury ◽  
Postoperative Patient ◽  
Radiographic Measurements ◽  
Patient Reported ◽  
Total Knee ◽  
End Stage

Abstract Background Total knee arthroplasty (TKA) is the major surgical treatment for end-stage osteoarthritis (OA). Despite its effectiveness, there are about 20% of patients who are dissatisfied with the outcome. Predicting the surgical outcome preoperatively could be beneficial in order to guide clinical decisions. Methods One-hundred and ten knees of 110 consecutive patients who underwent TKAs for varus knees resulting from OA were included in this study. Preoperative varus deformities were evaluated by femorotibial angle (FTA), medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA), and classified as a severe varus (SV) or a mild varus (MV) group. The osteophyte score (OS), which we developed originally, was also calculated based on the size of the osteophytes and classified as groups with more or less osteophytes. We compared preoperative and 1-year postoperative range of motion, the Knee Society Score, and Japanese Knee injury Osteoarthritis Outcome Score (KOOS) between SV and MV groups (varus defined by FTA, MPTA, or LDFA), in each group with more or less osteophytes. Results When varus deformities were defined by FTA, regardless of OS, postoperative KOOS subscales and/or the improvement rates were significantly higher in the SV group than in the MV group. When varus defined by MPTA, regardless of OS, there were no significant differences in postoperative KOOS subscales between groups. However, when varus defined by LDFA, scores for pain, activities of daily living (ADL), and quality of life (QOL) on postoperative KOOS and/or the improvement rates were significantly higher in the SV group than in the MV group only in patients with less osteophytes. No significant differences were found between groups in patients with more osteophytes. Conclusions We classified OA types by radiographic measurements of femur and tibia in combination with OS. Postoperative patient-reported outcomes were better in patients with SV knees but were poor in patients with knees with MV deformity and less osteophytes.

Sign in / Sign up

Export Citation Format

Share Document