Do Varus-valgus and Internal-external Malalignments of the Femoral Component in Kinematically Aligned Total Knee Arthroplasty Cause Clinically Important Changes in Contact Force Imbalance and Laxities of the Tibiofemoral Joint?

Download Do Varus-valgus and Internal-external Malalignments of the Femoral Component in Kinematically Aligned Total Knee Arthroplasty Cause Clinically Important Changes in Contact Force Imbalance and Laxities of the Tibiofemoral Joint? PDF Online Free

Author :
Publisher :
ISBN 13 : 9781339825830
Total Pages : pages
Book Rating : 4.8/5 (258 download)

DOWNLOAD NOW!


Book Synopsis Do Varus-valgus and Internal-external Malalignments of the Femoral Component in Kinematically Aligned Total Knee Arthroplasty Cause Clinically Important Changes in Contact Force Imbalance and Laxities of the Tibiofemoral Joint? by : Jeremy Alan Riley

Download or read book Do Varus-valgus and Internal-external Malalignments of the Femoral Component in Kinematically Aligned Total Knee Arthroplasty Cause Clinically Important Changes in Contact Force Imbalance and Laxities of the Tibiofemoral Joint? written by Jeremy Alan Riley and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Multiple metrics are used to evaluate knee function after total knee arthroplasty (TKA). One is the contact force imbalance between the medial and lateral compartments of the tibiofemoral joint. A second metric is the laxities of the tibiofemoral joint. Measuring contact forces in vitro is relatively fast, however measuring laxities in vitro is relatively slow. It is unknown how long the laxities in a human cadaveric knee can be measured before the soft tissues of the knee significantly degrade. Accordingly, the first aim of this research was to determine how many days laxities can be measured in a human cadaveric knee specimen with a TKA before clinically important changes occur. The goal of kinematically aligned total knee arthroplasty (KA TKA) is to restore native alignments of the limb, knee, and joint lines with the intent of restoring knee function to native without ligament release. During KA TKA there are two steps to set the alignment of the femoral component. First, the two distal condyles are resected, setting the varus-valgus (V-V), proximal-distal (P-D), and flexion-extension (F-E) degrees of freedom. Second, the two posterior condyles are resected, setting the internal-external (I-E) and anterior-posterior (A-P) degrees of freedom. The medial-lateral (M-L) position is set visually. The femoral component is kinematically aligned when the thicknesses of the distal and posterior resections of the femoral condyles are equal to the thicknesses of the corresponding portions of the femoral component after compensating for cartilage wear and kerf of the saw blade. However, the use of manual cutting guides and oscillating saws can lead to errors in making these resections. Errors in these resections can cause femoral component malalignment. Two important errors are V-V and I-E malalignment. These errors can lead to condylar lift-off, pain, tibial component loosening, early implant failure, and need for revision surgery. Additionally, it is also unknown whether changes in the laxities are correlated to changes in contact forces or contact force imbalance. This correlation is of interest to guide surgeons in assessing the alignment of the femoral component by checking laxities to determine whether tibial contact forces are balanced without direct measurement of these forces. Accordingly, the second aim of this research study was to determine: (1) whether 2° or 4° of V-V malalignment of the femoral component in KA TKA causes clinically important changes in contact force imbalance and laxities, (2) what degree of V-V malalignment causes a clinically important change in contact force imbalance of 67 N, and (3) whether each of eight changes in laxities was correlated to changes in medial contact force, lateral contact force, and contact force imbalance due to V-V malalignment. The third aim of this research study was to determine: (1) whether 2° or 4° of I-E malalignment of the femoral component in KA TKA causes clinically important changes in contact force imbalance and laxities, and (2) whether each of eight changes in laxities was correlated to changes in medial contact force, lateral contact force, and contact force imbalance due to I-E malalignment. Aim 1 KA TKA was performed on three human cadaveric knee specimens. The laxities and neutral positions in four degrees of freedom were measured for seven consecutive days using a six degree-of-freedom load application system. The earliest statistically significant and clinically important changes were found at the end of day 4, when the varus laxity (3.3° ± 1.3°) was significantly greater than the varus laxity at the beginning of day 1 (1.9° ± 0.5°, p 0.01). Aim 2 KA TKA was performed on ten human cadaveric knee specimens. V-V malalignment was introduced using 3D printed femoral components which simulated errors in the joint line of 2° varus rotation, 4° varus rotation, 2° valgus rotation, and 4° valgus rotation. Contact forces were measured using a custom tibial force sensor. Laxities were measured using a six degree-of-freedom load application system. A simple linear regression related the degree of V-V malalignment to the change in contact force imbalance. The correlation coefficient was computed for each combination of the eight changes in laxities and the changes in medial contact force, lateral contact force, and contact force imbalance. Statistically significant and clinically important changes in contact force imbalance occurred at 0° flexion with 2° varus (103 N), 4° varus (211 N), 2° valgus (89 N), and 4° valgus (178 N) malaligned femoral components (p 0.0010). A nearly perfect straight line (R2 0.99) relating the change in contact force imbalance at 0° flexion to the degree of V-V malalignment indicated that a V-V malalignment of 1.4° causes a change in contact force imbalance of 67 N. No clinically important changes in the laxities were found with the 2° or 4° malaligned femoral components. None of eight changes in laxities were strongly correlated (R2 0.5) with changes in medial contact force, lateral contact force, or contact force imbalance. Aim 3 KA TKA was performed on ten human cadaveric knee specimens. I-E malalignment was introduced using 3D printed femoral components which simulated errors in the joint line of 2° internal rotation, 4° internal rotation, 2° external rotation, and 4° external rotation. Contact forces were measured using a custom tibial force sensor. Laxities were measured using a six degree-of-freedom load application system. The correlation coefficient was computed for each combination of the eight changes in laxities and the changes in medial contact force, lateral contact force, and contact force imbalance. Statistically significant and clinically important changes in contact force imbalance occurred with the 4° internal component at 45° flexion (83 N), 60° flexion (110 N), 75° flexion (111 N), and 90° flexion (96 N) (p 0.0001). A statistically significant and clinically important change in the valgus laxity of 1.5° was found with 4° external component (p

How Well Does Kinematically Aligned Total Knee Arthroplasty Prevent Clinically Important Changes in Passive Knee Function?

Download How Well Does Kinematically Aligned Total Knee Arthroplasty Prevent Clinically Important Changes in Passive Knee Function? PDF Online Free

Author :
Publisher :
ISBN 13 : 9781339825557
Total Pages : pages
Book Rating : 4.8/5 (255 download)

DOWNLOAD NOW!


Book Synopsis How Well Does Kinematically Aligned Total Knee Arthroplasty Prevent Clinically Important Changes in Passive Knee Function? by : Joshua Daniel Roth

Download or read book How Well Does Kinematically Aligned Total Knee Arthroplasty Prevent Clinically Important Changes in Passive Knee Function? written by Joshua Daniel Roth and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Total knee arthroplasty (TKA) is the current standard of care for patients with severe osteoarthritis in their knee. In TKA, the damaged articular surfaces of the femur and tibia are replaced with orthopedic implants (i.e. the femoral and tibial components respectively). However, 20-25% of these patients report dissatisfaction after TKA using the traditional method of TKA, mechanically aligned TKA. By 2030, the prevalence of dissatisfaction could be 700,000 patients/year based on projected estimate of 3.5 million TKAs/year in the United States alone.The primary determinant of the clinical outcome of TKA is the alignment of the femoral and tibial components relative to their respective bones. The mechanically aligned TKA references anatomic landmarks that are unrelated to the function of the knee. A relatively new method for aligning the components, kinematically aligned TKA (KA TKA), references the articular surfaces with the goal of restoring the alignments of the limb, knee, and joint lines, and hence native knee function.Although patients report higher satisfaction and function at 6 months to 6 years after KA TKA, two unavoidable changes may prevent KA TKA from restoring passive knee function. The first is the replacement of the articular surfaces with implants of discrete sizes and average shapes. The second is resection of the anterior cruciate ligament (ACL). Accordingly, the overreaching aim of this research was to provide objective evidence using controlled in vitro experiments to evaluate passive joint function before and after KA TKA. Four metrics were determined to evaluate passive joint function: (1) the laxities (relative displacement of the tibia to the femur in a degree of freedom under an applied load), (2) the neutral positions (relative position/orientation of the tibia to the femur in a degree of freedom with no loads applied), (3) the contact force balance (difference between the contact forces in the medial and lateral compartments), and (4) contact kinematics (i.e. motion of the contact locations of the femoral component on the tibial component during flexion). Aim 1: Laxities and Neutral PositionsTo determine whether either or both of these unavoidable changes prevent KA TKA from restoring to native the laxities and neutral positions, the primary objectives were to determine how well KA TKA prevents clinically important (1) changes in the laxities and (2) shifts in the neutral positions in varus-valgus rotation, internal-external rotation, anterior-posterior translation, and compression-distraction relative to those of the native knee. The eight laxities and four neutral positions were measured from 0° to 120° of flexion in 30° increments in 13 native human cadaveric knees before and after KA TKA using a six degree-of-freedom load application system. The prevalence of clinically important changes in the 65 measured values (13 knees x 5 flexion angles) of each laxity after KA TKA was relatively low for all eight laxities. The highest prevalence occurred in external rotation laxity (21% exceeded 3.6°) and the lowest occurred in compression laxity (0% exceeded 1 mm). The prevalence of clinically important shifts in the 65 measured values of each neutral position after KA TKA was relatively low for internal-external rotation (20% exceeded 5°) and varus-valgus rotation (5% exceeded 1.5°), but was relatively high for the anterior-posterior (69% exceeded 1.1 mm) and compression-distraction (38% exceeded 1 mm). Aim 2: Laxities and Neutral Positions Imbalanced contact forces (> 67 N) and abnormal contact kinematics (i.e. anterior translation of the contact locations) of the femur on the tibia during passive flexion are associated with reduced satisfaction and limited flexion respectively after total knee arthroplasty (TKA). Although high satisfaction and function have been reported after kinematically aligned TKA (KA TKA) at 6 months to 6 years, no study has determined how well KA TKA prevents clinically important imbalances and abnormal contact kinematics during passive flexion. Accordingly, the objectives were to determine in vitro how well KA TKA prevents (1) imbalances between the contact forces in the medial and lateral compartments greater than 67 N, and (2) anterior translation of the contact locations in the medial and lateral compartments over an arc of flexion from 0° to 120°. The contact forces and contact locations were determined in both the medial and lateral compartments from 0° to 120° of flexion in 30°increments in six human cadaveric knees following KA TKA using a tibial contact force sensor implanted in place of the standard cruciate-retaining tibial component. The average contact forces remained balanced within 18 N, and the prevalence of clinically important imbalances in the 30 measured values (6 knees x 5 flexion angles) was 7%. The contact locations in both compartments translated posteriorly in all six KA TKA (i.e. prevalence of anterior translation = 0%) by an average of 16 mm and 18 mm in the medial and lateral compartments respectively from 0° to 120° of flexion. Conclusions KA TKA prevented clinically important changes/shifts in >̲ 79% of the measured values in ten of the twelve laxities/neutral positions, prevented clinically important contact force imbalances in 93% of the measured values, and prevented abnormal contact kinematics 100% of the knees despite the two unavoidable changes. These findings also help to explain the previously published clinical results that show KA TKA has a low risk of failure at 6 years and leads to high patient satisfaction and function at 6 months to 6 years which adds to the ever-growing compilation of evidence that justifies KA TKA as an acceptable alternative to the traditional alignment goals for TKA.

Soft Tissue Balancing in Total Knee Arthroplasty

Download Soft Tissue Balancing in Total Knee Arthroplasty PDF Online Free

Author :
Publisher : Springer
ISBN 13 : 3662540827
Total Pages : 267 pages
Book Rating : 4.6/5 (625 download)

DOWNLOAD NOW!


Book Synopsis Soft Tissue Balancing in Total Knee Arthroplasty by : Shuichi Matsuda

Download or read book Soft Tissue Balancing in Total Knee Arthroplasty written by Shuichi Matsuda and published by Springer. This book was released on 2017-05-02 with total page 267 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this booklet, experts from across the world, including members of the ISAKOS Knee Arthroplasty Committee, offer clear, up-to-date guidance on all aspects of soft tissue or ligament balancing in primary total knee arthroplasty with the aim of enabling the reader to achieve optimal patient outcomes. After an introduction explaining the normal soft tissue condition in the native knee, surgical procedures are described, including techniques for the management of severe deformity. The most striking feature of the booklet, however, is the many pages devoted to the accurate evaluation and clinical relevance of ligament balancing. Different techniques and devices for intraoperative soft tissue assessment are discussed, highlighting, for example, the use of gap-measuring devices or trial liners with load-bearing sensors to achieve more objective evaluation. Above all, special attention is devoted to the crucial issue of the impact of intraoperative soft tissue balance on postoperative results. In the closing chapter, very experienced surgeons introduce intraoperative troubleshooting in order to assist successful completion of arthroplasty.

Calipered Kinematically aligned Total Knee Arthroplasty

Download Calipered Kinematically aligned Total Knee Arthroplasty PDF Online Free

Author :
Publisher : Elsevier Health Sciences
ISBN 13 : 0323756271
Total Pages : 163 pages
Book Rating : 4.3/5 (237 download)

DOWNLOAD NOW!


Book Synopsis Calipered Kinematically aligned Total Knee Arthroplasty by : Stephen M. Howell

Download or read book Calipered Kinematically aligned Total Knee Arthroplasty written by Stephen M. Howell and published by Elsevier Health Sciences. This book was released on 2021-06-29 with total page 163 pages. Available in PDF, EPUB and Kindle. Book excerpt: Calipered kinematic alignment was proposed by Dr. Stephen M. Howell to enable the accurate and individualized placement of total knee components coincident within ± 0.5 mm of the patient’s pre-arthritic alignment. The aim was to restore the patient's native joint kinematics and thereby address the well documented 20% dissatisfaction when total knee replacement is performed using traditional, or mechanical alignment techniques. With Dr. Stefano A. Bini and Dr. G. Daxton Steele as co-editors, Dr. Howell has curated an international team of expert surgeons and engineers to discuss various aspects of the calipered knee alignment technique in short, concise, and well-illustrated chapters. Each author provides clear, practical guidance for adopting and implementing calipered kinematic alignment covering manual, patient-specific, navigated, and robotic techniques. Chapters on component design tailored explicitly for kinematic alignment and showing the close relationship between knee biomechanics and the kinematically aligned TKA help the surgeon manage complex challenges associated with deformity and post-operative complications. Following the introduction of the calipered kinematic alignment technique for total knee arthroplasty, many international studies have shown consistently better patient satisfaction than the traditional mechanical alignment technique. Better function and high long-term implant survival have catalyzed a paradigm shift in total knee replacement philosophy that is being embraced by orthopedic surgeons and innovative implant companies around the world with excellent results. Calipered Kinematically Aligned Knee Arthroplasty is the definitive textbook on the subject and features: Thorough explanations of how the calipered kinematic alignment technique for total knee arthroplasty accurately sets total knee components coincident with the patient’s pre-arthritic alignment and coaligned with the three rotational axes of the native knee. A personalized approach to total knee surgery designed to reconstitute the patient’s native biomechanics in contrast with mechanical alignment that place all patients in the same standard alignment regardless of their constitutional anatomy. Detailed and well-illustrated descriptions of manual, navigated, robotic and patient-specific guide techniques that confirm kinematic alignment with a caliper. Clinical photos, radiographs, and line art throughout the book as well as helpful online technique videos. Key focus topics such as managing complex deformities, the expected post-operative recovery, and future trends in kinematic alignment. The shared experience and knowledge of international pioneers in the field. An emphasis on a personalized surgical philosophy which enables same-day discharge, reduces pain and opioid use, and promotes quicker recovery, better function, and a more natural feeling knee.

Ligament Balancing in Total Knee Arthroplasty

Download Ligament Balancing in Total Knee Arthroplasty PDF Online Free

Author :
Publisher : Springer Science & Business Media
ISBN 13 : 3642592953
Total Pages : 116 pages
Book Rating : 4.6/5 (425 download)

DOWNLOAD NOW!


Book Synopsis Ligament Balancing in Total Knee Arthroplasty by : Leo A. Whiteside

Download or read book Ligament Balancing in Total Knee Arthroplasty written by Leo A. Whiteside and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 116 pages. Available in PDF, EPUB and Kindle. Book excerpt: The varus knee has a group of bone and ligament abnormalities that must be addressed to correct the deformity. The mechanical axis of the femur is tilted medially relative to the long axis of the tibia. The distal femoral surface usually remains in valgus alignment to the long axis of the femur. Most of the varus deformity is caused by deficiency in the medial tibial plateau. The deep and superficial medial collateral ligaments are contracted and deformed by osteophytes.

Sensitivity Of Total Knee Replacement Wear To Tibial Component Malrotation

Download Sensitivity Of Total Knee Replacement Wear To Tibial Component Malrotation PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (125 download)

DOWNLOAD NOW!


Book Synopsis Sensitivity Of Total Knee Replacement Wear To Tibial Component Malrotation by : Hannah Lundberg

Download or read book Sensitivity Of Total Knee Replacement Wear To Tibial Component Malrotation written by Hannah Lundberg and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Total Knee Replacement Wear is Most Sensitive to Transverse Plane Alignmentu2013 A Parametric Finite Element StudySteven P. Mell1, Markus A. Wimmer1, Joshua J. Jacobs1, Hannah J. Lundberg11Rush University Medical Center, Chicago, IL, [email protected]: Steven P. Mell (N), Markus A. Wimmer (5-Zimmer/Biomet), Joshua J. Jacobs (5-Zimmer/Biomet, Medtronics, Nuvasive), Hannah J. Lundberg (N) INTRODUCTION: Two major causes of failure of total knee replacements (TKRs) are component malalignment [1] and polyethylene wear [2]. Studies on component alignment and its effect on wear is relevant not only clinically but in the mechanical testing field, as small variations in alignment may account for the large inter- and intra-lab variability seen in wear tests [3]. In this study, the effect of 9 component alignment parameters on predicted volumetric wear in displacement control TKR simulations is investigated using a validated TKR finite element analysis (FEA) wear model combined with a Latin Hypercube Sampling (LHS) design of experiments (DOE) approach. A surrogate model generated using stepwise multiple linear regression is used to evaluate the effect on volumetric wear of each of the input parameters.METHODS: The effect of 9 component alignment parameters on TKR volumetric wear was investigated using a previously validated TKR FEA wear model [4] incorporated into a computational framework developed in the Isight Execution Engine (Dassault Systu00e8mes). This framework was used to run a 180-point LHS DOE of 9 component alignment parameters: the internal/external (IE) rotation of the femoral component, the IE rotation of the tibial component, the femoral component varus/valgus (VV) angle, the tibial insert anterior/posterior (AP) position, the tibial component rotation in the flexion/extension (FE) axis (tibial slope), the location of the femoral center of rotation (CoR) in both the AP and superior/inferior (SI) directions, and the location of the tibial IE axis in the medial/lateral (ML) direction. Baseline value (ISO), and bounds for the 9 parameters used in this study are found in Table 1. ISO 14243-3:2014 displacement control kinematic and loading inputs were used. To evaluate the effect each parameter had on wear and generate a surrogate model for use in the prediction of wear, step-wise multiple linear regression up to second order terms was performed on the results from the LHS DOE using MATLABu00ae v2017a (The Mathworks Inc.). In the step-wise approach, model terms that do not contribute to the explained variance of the model are excluded. An effects plot of volumetric wear was generated using the remaining terms in the model. The effects plot visualizes the maximum change on the output that can be elicited as the result of a change in a particular input parameter using the regression model, within the original bounds of the data. The range within which this change occurs is automatically calculated.RESULTS: Volumetric wear varied from 2.7 to 17.2 mm3/million cycles (MC) within the simulations performed. The step-wise linear regression algorithm generated a model that included all first order terms except for femoral component VV angle, and several interactions and second order terms (Table 1). All terms were significant (p

The Identification of Landmarks for Studying Component Alignment in Total Knee Arthroplasty

Download The Identification of Landmarks for Studying Component Alignment in Total Knee Arthroplasty PDF Online Free

Author :
Publisher :
ISBN 13 : 9781339261485
Total Pages : pages
Book Rating : 4.2/5 (614 download)

DOWNLOAD NOW!


Book Synopsis The Identification of Landmarks for Studying Component Alignment in Total Knee Arthroplasty by : Abheetinder Brar

Download or read book The Identification of Landmarks for Studying Component Alignment in Total Knee Arthroplasty written by Abheetinder Brar and published by . This book was released on 2015 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Purpose: Internal-external (I-E) malrotation of the tibial and femoral components is associated with poor function after total knee arthroplasty (TKA). Kinematically aligned (KA) TKA uses functionally defined flexion-extension (F-E) tibial and femoral reference lines, which are parallel to the F-E plane of the extended knee to set I-E rotation of the tibial and femoral components. We determined whether any of five anatomically defined tibial reference lines and three anatomically defined femoral reference lines used in mechanically aligned (MA) TKA was useful as an F-E reference line. Locating the true F-E axis of the knee can play an important role in component placement in TKA. It has been shown that the true F-E axis of the knee can be approximated by the visual-fit cylindrical axis. We determined whether a visual or computational-fit spherical axis is an accurate and reproducible substitute for the visual-fit cylindrical axis of the knee.The target alignment for the femoral component in KA TKA is in more internal, valgus, and flexion rotation than in MA TKA, which might reduce the proximal and lateral reach of the trochlea and therefore cause abnormal patellar tracking. The present study determined the reduction in proximal and lateral reach of the trochlea for a kinematically aligned femoral component and for flexion of a MA and KA femoral component. Methods: Sixty-two, three-dimensional bone models of normal knees were analyzed. We computed the bias as the mean and the imprecision as the standard deviation of the angle between the five tibial and three femoral reference lines and the F-E reference line (+ external/ - internal). The bias was tested for statistical significance. Forty three-dimensional bone models of native (i.e. healthy) knees constructed from magnetic resonance images (MRI) from the Osteoarthritis Initiative database (www.oai.ucsf.edu) were studied. Visual-fit and computational-fit methods were developed to locate the spherical axis. The visual-fit and computational-fit spherical axes were compared with the visual-fit cylindrical axis, which is the axis of a cylinder best fit to the tibial articular surface of each femoral condyle. Differences were computed with use of the dot product. Reproducibility was computed by having two observers perform measurements on fifteen knees, computing a simple linear regression, and testing the intercept of the regression equation for 0 and the slope for 1. We simulated the alignment of the femoral component on 20 three-dimensional bone models of normal femurs. The reference was the most proximal point of the trochlea of the target alignment of a MA femoral component. The MA and KA femoral components were aligned in 0°, 5°, 10°, and 15° of flexion and reduced in size until the flange contacted the anterior femur. The reductions in proximal and lateral reach were computed relative to the target alignment for the MA femoral component. Results: There was statistically significant bias between the tibial reference lines connecting the medial border (-2 °± 6°, p = 0.005), medial 1/3rd (6° ± 6°, p

Improving Accuracy in Knee Arthroplasty

Download Improving Accuracy in Knee Arthroplasty PDF Online Free

Author :
Publisher : JP Medical Ltd
ISBN 13 : 9350258706
Total Pages : 398 pages
Book Rating : 4.3/5 (52 download)

DOWNLOAD NOW!


Book Synopsis Improving Accuracy in Knee Arthroplasty by : Emmanuel Thienpont

Download or read book Improving Accuracy in Knee Arthroplasty written by Emmanuel Thienpont and published by JP Medical Ltd. This book was released on 2012-07-20 with total page 398 pages. Available in PDF, EPUB and Kindle. Book excerpt: Knee arthroplasty is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis. It may also be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. Improving Accuracy in Knee Arthroplasty discusses new technology allowing the design of implants to be adapted for individual patients. Beginning with an introduction to knee alignment and misalignment, the following sections examine anatomical landmarks in the normal and arthritic knee, instruments, navigation in knee arthroplasty, robotics and soft tissue guided surgery. With contributions from a renowned author and editor team from the UK, USA and Europe, this comprehensive manual includes more than 400 colour images and illustrations. Key Features Comprehensive guide to improving accuracy in knee arthroplasty Discusses new technology allowing implant design to be adapted to individual patients Renowned author and editor team from the UK, USA and Europe More than 400 colour images and illustrations

Total Knee Arthroplasty

Download Total Knee Arthroplasty PDF Online Free

Author :
Publisher : Springer
ISBN 13 : 3319175548
Total Pages : 278 pages
Book Rating : 4.3/5 (191 download)

DOWNLOAD NOW!


Book Synopsis Total Knee Arthroplasty by : E. Carlos Rodríguez-Merchán

Download or read book Total Knee Arthroplasty written by E. Carlos Rodríguez-Merchán and published by Springer. This book was released on 2015-06-15 with total page 278 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book offers a comprehensive guide to total knee arthroplasty (TKA) that will assist in achieving excellent outcomes based on a sound understanding and technique. After an introductory section on the native knee that covers the anatomy, physiology, biomechanics, and patterns of disease, all aspects of primary knee arthroplasty are discussed in detail. Individual chapters are devoted to topics such as acute pain management, the role of technological aids, prosthetic kinematics, alignment targets, unicompartmental arthroplasty, patellar resurfacing, outcome measures, and cost-effectiveness. An extensive section explains the causes and management of potential complications, including aseptic failure, infections, and periprosthetic fracture. The surgical techniques appropriate for revision knee arthroplasty are described separately, and guidelines on how to deal with bone loss, instability, and extensor mechanism failure are provided. The authors are all respected experts from the United Kingdom, United States, Australia and Europe.

Complex Cases in Total Knee Arthroplasty

Download Complex Cases in Total Knee Arthroplasty PDF Online Free

Author :
Publisher : Springer
ISBN 13 : 3319693808
Total Pages : 425 pages
Book Rating : 4.3/5 (196 download)

DOWNLOAD NOW!


Book Synopsis Complex Cases in Total Knee Arthroplasty by : Alfred J. Tria

Download or read book Complex Cases in Total Knee Arthroplasty written by Alfred J. Tria and published by Springer. This book was released on 2018-02-20 with total page 425 pages. Available in PDF, EPUB and Kindle. Book excerpt: Covering both primary and revision total knee arthroplasty (TKA), each technique-oriented chapter in this book opens with a clinical case and an overview of the challenges and multiple options for management, and each section within the chapter will describe the physical exam, surgical approach, clinical outcome and recent supporting literature. Chapters will utilize bullet points for quick reference and plentiful intra-operative photos to illustrate the various techniques described. Part one covers primary TKA, with cases demonstrating management strategies for the varus and valgus knee, flexion contracture, patellofemoral arthritis, and extra-articular deformity, among others, while part two covers revision TKA, with cases demonstrating acute infection, flexion and global instability, severe tibial and femoral bone loss, and periprosthetic fracture, among others. Written and edited by experts in the field, Complex Cases In Total Knee Arthroplasty: A Collection of Current Techniques will be a useful reference for orthopedic surgeons, residents and fellows as well as sports medicine specialists and anyone involved in surgical care of the knee.

Personalized Hip and Knee Joint Replacement

Download Personalized Hip and Knee Joint Replacement PDF Online Free

Author :
Publisher : Springer Nature
ISBN 13 : 3030242439
Total Pages : 346 pages
Book Rating : 4.0/5 (32 download)

DOWNLOAD NOW!


Book Synopsis Personalized Hip and Knee Joint Replacement by : Charles Rivière

Download or read book Personalized Hip and Knee Joint Replacement written by Charles Rivière and published by Springer Nature. This book was released on 2020-06-30 with total page 346 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book describes and illustrates the surgical techniques, implants, and technologies used for the purpose of personalized implantation of hip and knee components. This new and flourishing treatment philosophy offers important benefits over conventional systematic techniques, including component positioning appropriate to individual anatomy, improved surgical reproducibility and prosthetic performance, and a reduction in complications. The techniques described in the book aim to reproduce patients’ native anatomy and physiological joint laxity, thereby improving the prosthetic hip/knee kinematics and functional outcomes in the quest of the forgotten joint. They include kinematically aligned total knee/total hip arthroplasty, partial knee replacement, and hip resurfacing. The relevance of available and emerging technological tools for these personalized approaches is also explained, with coverage of, for example, robotics, computer-assisted surgery, and augmented reality. Contributions from surgeons who are considered world leaders in diverse fields of this novel surgical philosophy make this open access book will invaluable to a wide readership, from trainees at all levels to consultants practicing lower limb surgery

Simulation-based Stability Tests in Total Knee Arthroplasty

Download Simulation-based Stability Tests in Total Knee Arthroplasty PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : 72 pages
Book Rating : 4.:/5 (122 download)

DOWNLOAD NOW!


Book Synopsis Simulation-based Stability Tests in Total Knee Arthroplasty by : Brooke Kristine Delventhal

Download or read book Simulation-based Stability Tests in Total Knee Arthroplasty written by Brooke Kristine Delventhal and published by . This book was released on 2019 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt: Total knee arthroplasty (TKA) is known to be a successful procedure that can treat pain and disfunction caused by knee osteoarthritis (KOA). However, approximately 20% of patients are dissatisfied after surgery, with complications that have been linked to variable intraoperative procedures such as prosthetic component alignment and soft-tissue balancing techniques. The concept of kinematic alignment has been introduced to serve as an alternative to traditional mechanical alignment, where all patients’ bone cuts are made in the same way to restore a straight hip-knee-ankle line. Kinematic alignment instead aims to restore the anatomy of the native knee, without the need to balance the soft tissues. While many methods regarding soft-tissue balancing are subjective to surgeon decisions, new technology released by OrthoSensor serves to take tibiofemoral force measurements in each compartment of the knee during a passive range of motion, claiming that equal contact forces within various thresholds presume knee balance. However, biomechanical knee balance is defined using the amount of knee motion resulting from a known applied force, which we have quantified with a novel knee stability device. The purpose of this study was to investigate the relationship of these contact force measurements to biomechanical knee laxity and prosthetic component alignment, as well as to explore the clinical utility of using contact forces and component alignments to predict knee laxity. These relationships were explored by creating a model of the lower limb in OpenSim 4.0 that incorporated contact meshes of the prosthetic components and varying properties of ligament stiffnesses to represent five different types of knees. 790 forward dynamic simulations were run at multiple flexion angles, applying increasing and decreasing torque to move the knee in the varus-valgus direction. Correlations were calculated between contact forces, knee laxity, and component alignment, and forward step-wise regressions were done to try to predict laxity using inputs of contact and alignment. Balanced contact forces did not show a consistent association with balanced knee laxity, but higher contact forces were generally associated with decreased laxity. However, contact measurements did not have a consistent significant effect in the prediction of knee laxity, which adds to the lack of support for the utilization of these measurements. Tibiofemoral contact was also quite sensitive to component alignment changes, which supports the idea that kinematically-aligned TKAs should not use a force target when balancing the knee, as patient-specific alignment entails patient-specific contact forces. Overall, the relationships between tibiofemoral contact and biomechanical knee function were inconsistent and therefore the use of these contact forces in soft-tissue balancing is not supported. More research should be done in modeling these forces during daily activities to explore a relationship between contact forces and active functionality.

Total Knee Arthroplasty

Download Total Knee Arthroplasty PDF Online Free

Author :
Publisher : Springer Science & Business Media
ISBN 13 : 9783540202424
Total Pages : 440 pages
Book Rating : 4.2/5 (24 download)

DOWNLOAD NOW!


Book Synopsis Total Knee Arthroplasty by : Johan Bellemans

Download or read book Total Knee Arthroplasty written by Johan Bellemans and published by Springer Science & Business Media. This book was released on 2005 with total page 440 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Take away my knee pain and give me better motion." This is what the arthritic patient expects from a Total Knee Arthroplasty (TKA). By virtue of standardization of the TKA procedure, surgeons can nowadays solve the pain issue for the majority of the patients. Restoration of function is a goal of a different order and forms the scope of this book. The editors confronted today's leading knee surgeons with the limitations of current surgical techniques and technology. They challenged them to define new thresholds of functional capacity after Total Knee Arthroplasty. "A Guide to Get Better Performance in TKA" describes the cutting edge in surgical techniques, prosthetic design and achievement of excellent function for these patients.

Does Mechanical Alignment in Total Knee Arthroplasty Cause Collateral Ligament Instability and Change Limb and Knee Alignment from Normal?

Download Does Mechanical Alignment in Total Knee Arthroplasty Cause Collateral Ligament Instability and Change Limb and Knee Alignment from Normal? PDF Online Free

Author :
Publisher :
ISBN 13 : 9781321016352
Total Pages : pages
Book Rating : 4.0/5 (163 download)

DOWNLOAD NOW!


Book Synopsis Does Mechanical Alignment in Total Knee Arthroplasty Cause Collateral Ligament Instability and Change Limb and Knee Alignment from Normal? by : Yy Gu

Download or read book Does Mechanical Alignment in Total Knee Arthroplasty Cause Collateral Ligament Instability and Change Limb and Knee Alignment from Normal? written by Yy Gu and published by . This book was released on 2014 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: In mechanically aligned total knee arthroplasty (TKA), there are two strategies for aligning the components in the coronal plane. The first strategy references the mechanical axes of the femur and tibia and sets the limb at a 0℗ʻ hip-knee-ankle angle. The second strategy references the anatomic axes of the femur and tibia and sets the knee at 5° or 7° valgus. However, these strategies may cause undesirable consequences recognized as a tight collateral ligament in 0℗ʻ of extension, instability in a compartment between 0° of extension and 90° of flexion that is uncorrectable by collateral ligament release, and a change in limb and knee alignment from normal. The goal of this research project was to determine the frequency and range of these undesirable consequences. Methods: The TKA was simulated on fifty three-dimensional bone models of normal lower extremities from white subjects. To establish a repeatable projection from which to make the measurements, the simulations were performed on the limb projected in the sagittal, coronal, and axial kinematic planes. In the coronal kinematic plane, mechanically aligned TKA was simulated using each of the two strategies: (1) setting the limb at a 0° hip-knee-ankle angle, and (2) setting knee at 5° or 7° valgus. In the axial kinematic plane, the internal-external rotation of the femoral component was set using each of the four methods: (Method 1) perpendicular to the anteroposterior axis of the trochlear groove), (Method 2) parallel to the transepicondylar axis, (Method 3) 3° externally rotated to the posterior condylar axis, and (Method 4) parallel to the tibial resection at 90° flexion with the use of gap-balancing. Results: The percentage of simulated TKAs that required ≥ 2 mm release of a tight collateral ligament at 0° of extension was 58% with the limb at a 0° hip-knee-ankle angle, 60% with the knee set at 5° valgus, and 64% with the knee set at 7° valgus. For Methods 1-3, the percentage of simulated TKAS that had ≥ 2 mm ligament instability in a compartment between 0° of extension and 90° of flexion that is uncorrectable by collateral ligament release was 56%, 74%, and 42% respectively with the limb set at a 0° hip-knee-ankle angle, 60%, 58%, and 54% respectively with the knee set at 5° valgus, and 64%, 74%, and 48% respectively with the knee set at 7° valgus. Gap balancing Method 4 did not cause ligament when used with any of the coronal alignment strategies. The percentage of simulated TKAS that had ≥ 2° change in limb and knee alignment was 58% with the limb set at a 0° hip-knee-ankle angle, 60% with the knee set at 5° valgus, and 64% with the knee set at 7° valgus. Discussion: Surgeons should be aware when they mechanically align a TKA with the limb set at a 0° hip-knee-ankle angle and the knee set at 5° or 7° valgus with four different methods for setting the internal-external rotation of the femoral component, that they will frequently have to manage a wide range of instabilities that are complex, cumulative, and uncorrectable by collateral ligament release, and a wide range of change in limb and knee alignment from normal. Patients who perceive these changes in stability, limb alignment, and knee alignment may be dissatisfied and require counseling.

Total Knee Arthroplasty

Download Total Knee Arthroplasty PDF Online Free

Author :
Publisher : Lippincott Williams & Wilkins
ISBN 13 :
Total Pages : 488 pages
Book Rating : 4.3/5 (91 download)

DOWNLOAD NOW!


Book Synopsis Total Knee Arthroplasty by : James Alan Rand

Download or read book Total Knee Arthroplasty written by James Alan Rand and published by Lippincott Williams & Wilkins. This book was released on 1993 with total page 488 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive reference on total knee arthroplasty describes all surgical techniques and prosthetic designs for primary and revision arthroplasty, discusses every aspect of patient selection, preoperative planning, and intraoperative and postoperative care.

LCS® Mobile Bearing Knee Arthroplasty

Download LCS® Mobile Bearing Knee Arthroplasty PDF Online Free

Author :
Publisher : Springer Science & Business Media
ISBN 13 : 364259347X
Total Pages : 374 pages
Book Rating : 4.6/5 (425 download)

DOWNLOAD NOW!


Book Synopsis LCS® Mobile Bearing Knee Arthroplasty by : Karel J. Hamelynck

Download or read book LCS® Mobile Bearing Knee Arthroplasty written by Karel J. Hamelynck and published by Springer Science & Business Media. This book was released on 2013-11-11 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: Worldwide experience with the Lcs• mobile bearing total knee prosthesis has been unpar alleled both in terms of enduring popularity and outstanding long-term clinical results. Buechel and Pappas's design was based on the principles of; restoring anatomical joint function to as near normal as possible, minimising contact stresses to avoid wear and darn age to the bearing surfaces. and finally the idea that constraint should refiect the need for mobility, to avoid shear stresses and loosening of the implant. In 1977, the LCS® knee was implanted by Dr. Frederick Buechel. This was the first mobile bearing, tri-compartmental knee implant. This was also the first to successfully address the key issues ofloosening, wear and patello-femoral problems associated with earlier designs. The unique design solution was the creation of a common articulating geometry for the tibia and patella on the distal femoral surface. This resulted in a tibial and patellar articulation that was mobile in nature, but with an identical radius of curvature and conformity. The mobile bearing concept was considered sufficiently novel and unproven that the US FDA (Food & Drug Administration) required that it be validated in an Investigational Device Evaluation (IDE). An FDA IDE study involving 25 US surgeons was initiated in 1981. Validation of the clinical success of the device in this study resulted in FDA approval of the LCS, Knee (for cemented, tri-compartmental use) in 1985.

Controversies of Total Knee Arthroplasty

Download Controversies of Total Knee Arthroplasty PDF Online Free

Author :
Publisher : Raven Press (ID)
ISBN 13 :
Total Pages : 344 pages
Book Rating : 4.3/5 (91 download)

DOWNLOAD NOW!


Book Synopsis Controversies of Total Knee Arthroplasty by : Victor M. Goldberg

Download or read book Controversies of Total Knee Arthroplasty written by Victor M. Goldberg and published by Raven Press (ID). This book was released on 1991 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: Physicians, surgeons and scientists look at the major problems encountered in total knee replacement. Key issues addressed include design of prosthetic knee components, wear of articular surfaces, fixation, patellar replacement, surgical technique and revision arthroplasty.