Clinical Results and Influence of Patellofemoral Joint Design on the Stability of the Patellar Component in Miller-Galante Types I and II, and Nexgen Total Knee Arthroplasty

1999 ◽  
pp. 292-305
Author(s):  
Shaw Akizuki ◽  
Tsutomu Takizawa ◽  
Hiroshi Horiuchi ◽  
Yukihiro Yasukawa ◽  
Hirokazu Kobayashi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patellofemoral Joint ◽  
Clinical Results ◽  
Patellar Component ◽  
Joint Design ◽  
Total Knee ◽  
The Stability

Evaluation and Analysis of the Onlay Patellar Component in Total Knee Arthroplasty

2010 ◽  
Vol 97-101 ◽  
pp. 3773-3776 ◽  
Author(s):  
Chien Wei Liu ◽  
Chia Chi Lo ◽  
Ching Sung Wang ◽  
Chen Tung Yu
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Three Dimensional ◽  
Element Model ◽  
Clinical Results ◽  
Original Design ◽  
Design Modification ◽  
Patellar Component ◽  
Significant Difference ◽  
Total Knee

Complications in total knee arthroplasty (TKA), which may include the inaccuracy of the implantation and the poor component design, can cause major failures in the TKA. Therefore, the present investigation studies the onlay knee implants commonly used clinically to find the major causes of the damage to artificial patella by the computer aided analysis of the three-dimensional finite element model of the artificial patello-femoral joint built through reverse engineering. Results showed that although a significant difference is found in the condition and the state of the stress distribution generated as the patello-femoral joint changes with the flexion of the knees, this variation is still within the tolerable range; but the patellar lateral tilt is something that caught our attention. Furthermore, through the comparison between the study and the clinical results, this investigation concludes that the bone cement on the implant interface is the major cause for the breaking of the pegs, and is not related to the original design of the patella. This study also discovers that slight design modification on the parts of commonly used artificial joints may effectively reduce surgical failure rate; therefore, a more robust design configuration for patellar pegs is proposed.

scholarly journals FRI0418 SELECTIVE PATELLAR RESURFACING IN TOTAL KNEE ARTHROPLASTY FOR THE OSTEOARTHRITIC KNEE: A PROSPECTIVE STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 807.3-807
Author(s):  
I. Moriyama
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcome ◽  
Knee Arthroplasty ◽  
Patellofemoral Joint ◽  
Osteoarthritis Of The Knee ◽  
Patellar Resurfacing ◽  
Criterion A ◽  
Total Knee ◽  
The Mean

Background:No widely accepted view or criteria currently exist concerning whether or not patellar replacement (resurfacing) should accompany total knee arthroplasty for osteoarthritis of the knee.1)2)3)Objectives:We recently devised our own criteria for application of patellar replacement and performed selective patellar replacement in accordance with this set of criteria. The clinical outcome was analyzed.Methods:The study involved 1150 knees on which total knee arthroplasty was performed between 2005 and 2019 because of osteoarthritis of the knee. The mean age at operation was 73, and the mean postoperative follow-up period was 91 months. Our criteria for application of patellar replacement are given below. Criterion A pertains to evaluation of preoperative clinical symptoms related to the patellofemoral joint: (a) interview regarding presence/absence of pain around the patella, (b) cracking or pain heard or felt when standing up from a low chair, (c) pain when going upstairs/downstairs. Because it is difficult for individual patients to identify the origin of pain (patellofemoral joint or femorotibial joint), the examiner advised each patient about the location of the patellofemoral joint when checking for these symptoms. Criterion B pertains to intense narrowing or disappearance of the patellofemoral joint space on preoperative X-ray of the knee. Criterion C pertains to the intraoperatively assessed extent of patellar cartilage degeneration corresponding to class 4 of the Outerbridge classification. Patellar replacement was applied to cases satisfying at least one of these sets of criteria (A-a,-b,-c, B and C). Postoperatively, pain of the patellofemoral joint was evaluated again at the time of the last observation, using Criterion A-a,-b,-c.Results:Patellar replacement was applied to 110 knees in accordance with the criteria mentioned above. There were 82 knees satisfying at least one of the Criterion sets A-a,-b,-c, 39 knees satisfying Criterion B and 70 knees satisfying Criterion C. (Some knees satisfied 2 or 3 of Criteria A, B and C).When the pain originating from patellofemoral joint (Criterion A) was clinically assessed at the time of last observation, pain was not seen in any knee of the replacement group and the non-replacement group.Conclusion:Whether or not patellar replacement is needed should be determined on the basis of the symptoms or findings related to the patellofemoral joint, and we see no necessity of patellar replacement in cases free of such symptoms/findings. When surgery was performed in accordance with the criteria on patellar replacement as devised by us, the clinical outcome of the operated patellofemoral joint was favorable, although the follow-up period was not long. Although further follow-up is needed, the results obtained indicate that selective patellar replacement yields favorable outcome if applied to cases judged indicated with appropriate criteria.References:[1]The Effect of Surgeon Preference for Selective Patellar Resurfacing on Revision Risk in Total Knee Replacement: An Instrumental Variable Analysis of 136,116 Procedures from the Australian Orthopaedic Association National Joint Replacement Registry.Vertullo CJ, Graves SE, Cuthbert AR, Lewis PL J Bone Joint Surg Am. 2019 Jul 17;101(14):1261-1270[2]Resurfaced versus Non-Resurfaced Patella in Total Knee Arthroplasty.Allen W1, Eichinger J, Friedman R. Indian J Orthop. 2018 Jul-Aug;52(4):393-398.[3]Is Selectively Not Resurfacing the Patella an Acceptable Practice in Primary Total Knee Arthroplasty?Maradit-Kremers H, Haque OJ, Kremers WK, Berry DJ, Lewallen DG, Trousdale RT, Sierra RJ. J Arthroplasty. 2017 Apr;32(4):1143-1147.Disclosure of Interests:None declared

scholarly journals Varus–valgus stability at 90° flexion correlates with the stability at midflexion range more widely than that at 0° extension in posterior-stabilized total knee arthroplasty

2017 ◽  
Vol 137 (10) ◽  
pp. 1429-1434 ◽  
Author(s):  
Kazunori Hino ◽  
Tatsuhiko Kutsuna ◽  
Kunihiko Watamori ◽  
Hiroshi Kiyomatsu ◽  
Yasumitsu Ishimaru ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Posterior Stabilized ◽  
Total Knee ◽  
The Stability

Effect of Gait on Patellofemoral Mechanics

2008 ◽  
Author(s):  
Jeffrey E. Bischoff ◽  
Justin S. Hertzler
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Clinical Studies ◽  
Patellofemoral Joint ◽  
Knee Kinematics ◽  
Component Design ◽  
Total Knee ◽  
The Impact ◽  
Reconstructed Knee

Computational modeling of the reconstructed knee is an important tool in designing components for maximum functionality and life. Utilization of boundary conditions consistent with in vivo gait loading in such models enables predictions of knee kinematics and polyethylene damage [1–4], which can then be used to optimize component design. Several recent clinical studies have focused on complications associated with the patellofemoral joint [5–6], highlighting the need to better understand the mechanics of this compartment of total knee arthroplasty (TKA). This study utilizes a computational model to characterize the impact of gait loading on the mechanics of the patella in TKA.

Evaluation of the patellofemoral joint in total knee arthroplasty: Validation of the weight bearing merchant radiographic view

The Knee ◽  
2018 ◽  
Vol 25 (6) ◽  
pp. 1262-1271 ◽  
Author(s):  
Monther A. Gharaibeh ◽  
Elizabeth Monk ◽  
Darren B. Chen ◽  
Samuel J. MacDessi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patellofemoral Joint ◽  
Weight Bearing ◽  
Total Knee

scholarly journals Slight femoral under-correction versus neutral alignment in total knee arthroplasty with preoperative varus knees: a comparative study

Arthroplasty ◽  
2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Kai Lei ◽  
Li-Ming Liu ◽  
Peng-Fei Yang ◽  
Ran Xiong ◽  
De-Jie Fu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Clinical Results ◽  
Patient Reported Outcome Measures ◽  
Tourniquet Time ◽  
Patient Reported ◽  
Total Knee ◽  
Neutral Alignment

Abstract Background This study aimed to compare the short-term clinical results of slight femoral under-correction with neutral alignment in patients with preoperative varus knees who underwent total knee arthroplasty. Methods The medical records and imaging data were retrospectively collected from patients who had undergone total knee arthroplasty in our hospital from January 2016 to June 2019. All patients had varus knees preoperatively. Upon 1:1 propensity score matching, 256 patients (256 knees) were chosen and divided into a neutral alignment group (n=128) and an under-correction group (n=128). The patients in the neutral group were treated with the neutral alignment. In the under-correction group, the femoral mechanical axis had a 2° under-correction. The operative time, tourniquet time and the length of hospital stay in the two groups were recorded. The postoperative hip-knee-ankle angle, frontal femoral component angle and frontal tibial component angle were measured. Patient-reported outcome measures were also compared. Results The operative time, tourniquet time and the length of hospital stay in the under-correction group were significantly shorter than the neutral alignment group (P<0.05). At the 2-year follow-up, the under-correction group had a larger varus alignment (P<0.05) and a larger frontal femoral component angle (P<0.05), and the frontal tibial component angles of the two groups were comparable. Compared with the neutral alignment group, the slight femoral under-correction group had significantly better patient-reported outcome measures scores (P<0.05). Conclusion For varus knees treated with total knee arthroplasty, alignment with a slight femoral under-correction has advantages over the neutral alignment in terms of the shorter operative time and better short-term clinical results. Level of evidence III

FATE OF THE UNREVISED ALL-POLYETHYLENE PATELLAR COMPONENT IN REVISION TOTAL KNEE ARTHROPLASTY

2003 ◽  
Vol 85 (1) ◽  
pp. 56-59 ◽  
Author(s):  
JESS H. LONNER ◽  
MICHAEL A. MONT ◽  
PETER F. SHARKEY ◽  
JOHN M. SILISKI ◽  
AMAR D. RAJADHYAKSHA ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Patellar Component ◽  
Total Knee
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