Knee Joint Biomechanics and Neuromuscular Control During Gait Before and After Total Knee Arthroplasty are Sex-specific

2015 ◽  
Vol 30 (1) ◽  
pp. 118-125 ◽  
Author(s):  
Janie L. Astephen Wilson ◽  
Michael J. Dunbar ◽  
Cheryl L. Hubley-Kozey
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Neuromuscular Control ◽  
Before And After ◽  
Joint Biomechanics ◽  
Total Knee

Quantifying Achievable Levels of Improvement in Knee Joint Biomechanics During Gait After Total Knee Arthroplasty Relative to Osteoarthritis Severity

2020 ◽  
pp. 1-9
Author(s):  
Jereme B. Outerleys ◽  
Michael J. Dunbar ◽  
Glen Richardson ◽  
Cheryl L. Hubley-Kozey ◽  
Janie L. Astephen Wilson
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Frontal Plane ◽  
Knee Adduction Moment ◽  
Patient Specific ◽  
Knee Biomechanics ◽  
Knee Oa ◽  
Joint Biomechanics ◽  
Total Knee

Total knee arthroplasty (TKA) surgery improves knee joint kinematics and kinetics during gait for most patients, but a lack of evidence exists for the level and incidence of improvement that is achieved. The objective of this study was to quantify patient-specific improvements in knee biomechanics relative to osteoarthritis (OA) severity levels. Seventy-two patients underwent 3-dimensional (3D) gait analysis before and 1 year after TKA surgery, as well as 72 asymptomatic adults and 72 with moderate knee OA. A combination of principal component analysis and discriminant analyses were used to categorize knee joint biomechanics for patients before and after surgery relative to asymptomatic, moderate, and severe OA. Post-TKA, 63% were categorized with knee biomechanics consistent with moderate OA, 29% with severe OA, and 8% asymptomatic. The magnitude and pattern of the knee adduction moment and angle (frontal plane features) were the most significant contributors in discriminating between pre-TKA and post-TKA knee biomechanics. Standard of care TKA improves knee biomechanics during gait to levels most consistent with moderate knee OA and predominately targets frontal plane features. These results provide evidence for the level of improvement in knee biomechanics that can be expected following surgery and highlight the biomechanics most targeted by surgery.

Knee joint biomechanics of patients with unilateral total knee arthroplasty during stationary cycling

2020 ◽  
pp. 110111
Author(s):  
Erik Hummer ◽  
Tanner Thorsen ◽  
Joshua T. Weinhandl ◽  
Harrold Cates ◽  
Songning Zhang
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Joint Biomechanics ◽  
Total Knee

scholarly journals A patient-specific 3D model of the knee to compare the femoral rollback before and after total knee arthroplasty (TKA)

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Alexandra Mercader ◽  
Timon Röttinger ◽  
Amir Bigdeli ◽  
Tim C. Lüth ◽  
Heinz Röttinger
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
3D Model ◽  
Standard Procedure ◽  
Patient Specific ◽  
Number Of Patients ◽  
Before And After ◽  
Total Knee ◽  
The Impact

Abstract Purpose Total knee arthroplasty (TKA) is nowadays performed as a standard procedure on a large number of patients suffering from arthrosis. Replacing the knee joint causes changes in the geometry and kinematics of the knee, which are unique to each individual. This research focuses on the method to detect these changes after TKA and on the impact on the knee movement. This approach could reduce complications in patients with post-operative pain and reduce the number of revisions. Methods A 3D model of a patient’s knee was made by measuring the movement with a medically certified infrared stereo camera. This measurement was combined with the 3D model of the patient’s bones, previously segmented from the CT scan. This model is printed in 3D, one part being the mechanism that follows the movement of the patient, and the other part being the 3D copy of the femur and tibia bones. The knee replacement operation is performed directly on the model and the resulting rollback is being measured before and after TKA. Results We observe a difference in the rollback before and after TKA on the 3D printed model. The variation in size and shape of the femoral implant compared to the natural femur condyles is one of the reasons for the changes in the rollback effect. The rollback is half as large after the prosthesis insertion, which confirms the fact that the femoral prosthesis geometry influences the knee kinematics. Conclusions In this study, a first 3D model combining the patient-specific kinematic and the geometry of his bones has been constructed. This model allows the surgeon to validate the plan of the operation, but also to understand the problems and consequences generated by the prosthesis insertion. The rollback is one of the most important motion of the knee joint and this behavior could be quantified, providing comparative analysis of the knee joint before and after the operation. As a future study, the model could be used to analyse more parameters of the TKA such as the impact of different implantation methods.

scholarly journals Postoperative laxity of the lateral soft tissue is largely negligible in total knee arthroplasty for varus osteoarthritis

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110020
Author(s):  
Seikai Toyooka ◽  
Hironari Masuda ◽  
Nobuhiro Nishihara ◽  
Takashi Kobayashi ◽  
Wataru Miyamoto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Varus Deformity ◽  
Varus Knee ◽  
Before And After ◽  
Knee Deformity ◽  
Varus Stress ◽  
Total Knee

Purpose: To evaluate the integrity of lateral soft tissue in varus osteoarthritis knee by comparing the mechanical axis under varus stress during navigation-assisted total knee arthroplasty before and after compensating for a bone defect with the implant. Methods: Sixty-six knees that underwent total knee arthroplasty were investigated. The mechanical axis of the operated knee was evaluated under manual varus stress immediately after knee exposure and after navigation-assisted implantation. The correlation between each value of the mechanical axis and degree of preoperative varus deformity was compared by regression analysis. Results: The maximum mechanical axis under varus stress immediately after knee exposure increased in proportion to the degree of preoperative varus deformity. Moreover, the maximum mechanical axis under varus stress after implantation increased in proportion to the degree of preoperative varus deformity. Therefore, the severity of varus knee deformity leads to a progressive laxity of the lateral soft tissue. However, regression coefficients after implantation were much smaller than those measured immediately after knee exposure (0.99 vs 0.20). Based on the results of the regression formula, the postoperative laxity of the lateral soft tissue was negligible, provided that an appropriate thickness of the implant was compensated for the bone and cartilage defect in the medial compartment without changing the joint line. Conclusion: The severity of varus knee deformity leads to a progressive laxity of the lateral soft tissue. However, even if the degree of preoperative varus deformity is severe, most cases may not require additional procedures to address the residual lateral laxity.

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

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

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

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