Biomechanical analysis on total knee replacement patients during gait: Medial pivot or posterior stabilized design?

2020 ◽  
Vol 78 ◽  
pp. 105068
Author(s):  
Francesco Esposito ◽  
Marco Freddolini ◽  
Massimiliano Marcucci ◽  
Leonardo Latella ◽  
Andrea Corvi
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Biomechanical Analysis ◽  
Posterior Stabilized ◽  
Medial Pivot ◽  
Total Knee

The Effects of Resection Technique on Implant Migration in Single Radius Posterior-Stabilized Total Knee Replacement

2018 ◽  
Vol 33 (01) ◽  
pp. 078-083
Author(s):  
Matthew G. Teeter ◽  
Kevin Perry ◽  
Xunhua Yuan ◽  
James L. Howard ◽  
Brent A. Lanting
Keyword(s):  
Total Knee Replacement ◽  
Femoral Component ◽  
Knee Replacement ◽  
Tibial Component ◽  
Posterior Stabilized ◽  
Gap Balancing ◽  
Measured Resection ◽  
Total Knee ◽  
Single Radius ◽  
Component Migration

AbstractThe purpose of the present study was to measure the effects of gap balancing and resection techniques on migration of a single total knee replacement implant design. A total of 23 patients (24 knees) were recruited on referral to either a surgeon performing gap balancing or a surgeon performing measured resection and followed prospectively. All patients received a fixed bearing, posterior stabilized total knee replacement implant of a single radius femoral component design with cement fixation, and all aspects of care outside of resection technique were identical. Patients underwent radiostereometric analysis (RSA) at 2 weeks (baseline), 6 weeks, 3 months, 6 months, 1 year, and 2 years. Migration of the tibial and femoral components was compared between groups. Tibial component migration was greater at 2 years in the gap balancing group (mean difference = 0.336 mm, p = 0.036), but there was no difference at 1 year. One measured resection and three gap balancing tibial components demonstrated continuous migration > 0.2 mm between years 1 and 2. There was no difference in femoral component migration. Small differences in tibial component migration were found between the gap balancing and measured resection techniques. However, comparing the migration to established predictive thresholds for long-term loosening risk, implants performed with both techniques were found to have equally low revision risk.

scholarly journals The Effect on Long Term Survivorship of Surgeon Preference for Posterior Stabilized or Minimally Stabilized Total Knee Replacement: An Analysis of 63416 Cases from the AOANJRR

2017 ◽  
Vol 5 (5_suppl5) ◽  
pp. 2325967117S0017
Author(s):  
Christopher Vertullo ◽  
Peter Lewis ◽  
Michelle Lorimer ◽  
Stephen Graves
Keyword(s):  
Total Knee Replacement ◽  
Selection Bias ◽  
Knee Replacement ◽  
High Volume ◽  
Patellar Resurfacing ◽  
Posterior Stabilized ◽  
Observational Series ◽  
Total Knee ◽  
Optimum Management

Introduction & Aims: Controversy still exists as to the optimum management of the PCL in TKR, with registry data suggesting Posterior Stabilised TKR have a higher Cumulative Percent Revision (CPR) compared to Minimally Stabilised TKR. Proponents of PS TKR suggest this difference is due to selection bias as result of preferential use of PS TKR in complex or more severe cases. To remove this selection bias, we aimed to compare CPR based on surgeon TKR stability preference to treat with PS or MS TKR rather than actual prosthesis type received. Method: Observational series. An analysis of AOANJRR data from 1999 – 2014 was utilized to identify two cohorts of high volume surgeons who preferred to use routinely either MS or PS TKR. Only fixed tibial inserts and patellar resurfacing TKR were included. A MS preferring surgeon used MS TKR at least 90% of the time and a PS preferring surgeon used PS TKR at least 90% of the time. Consequently, each patient cohort included both PS and MS TKR in differing proportions. Results: Procedures undertaken by PS preferring surgeons had a significantly higher risk of revision (CPR (Hazard Ratio = 1.45 (95% CI 1.30, 1.63), p< 0.001). There was a higher rate of revision for loosening and infection in the PS group. Of the 39 941 TKR with cemented fixation of both femur and tibia, the PS preferring surgeons had a higher CPR than the MS preferring cohort (HR = 1.55 (1.33, 1.80), p< 0.001). Regardless of whether the polyethylene was crosslinked or non-crosslinked, the MS preferring surgeons had a lower CPR compared to the PS preferring surgeons. Conclusions: In this analysis, procedures undertaken by surgeons who mainly preferred to use PS TKR had a higher rate of revision than those that mainly used MS TKR. This finding was irrespective of patient age and was also evident when fixation and the type of polyethylene used was taken into account.

Cementless Versus Cemented Tibial Fixation in Posterior Stabilized Total Knee Replacement

2020 ◽  
Vol 102 (12) ◽  
pp. 1075-1082 ◽  
Author(s):  
Nils Oscar Nivbrant ◽  
Riaz J.K. Khan ◽  
Daniel P. Fick ◽  
Samantha Haebich ◽  
Ewan Smith
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Posterior Stabilized ◽  
Tibial Fixation ◽  
Total Knee

scholarly journals Traumatic Dislodgement of Tibial Polyethylene Insert after a High-Flex Posterior-Stabilized Total Knee Replacement

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Juan Felix Astoul Bonorino ◽  
Pablo Ariel Isidoro Slullitel ◽  
Gonzalo Rodrigo Kido ◽  
Santiago Bongiovanni ◽  
Renato Vestri ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Mobile Bearing ◽  
Polyethylene Insert ◽  
Fixed Bearing ◽  
Posterior Stabilized ◽  
Cruciate Retaining ◽  
Tibial Insert ◽  
Total Knee ◽  
Similarities And Differences

Many pathologic entities can produce a painful total knee replacement (TKR) that may lead to potential prosthetic failure. Polyethylene insert dissociation from the tibial baseplate has been described most frequently after mobile-bearing and cruciate-retaining TKRs. However, only 3 tibial insert dislocations in primary fixed-bearing High-Flex posterior-stabilized TKRs have been reported. We present a new case of tibial insert dislocation in a High-Flex model that shares similarities and differences with the cases reported, facilitating the analysis of the potential causes, which still remain undefined.

Posterior stabilized component increased femoral bone loss after total knee replacement. 5-year follow-up of 47 knees using dual energy X-ray absorptiometry

The Knee ◽  
2006 ◽  
Vol 13 (6) ◽  
pp. 435-439 ◽  
Author(s):  
Tuuli Saari ◽  
Johan Uvehammer ◽  
Lars V. Carlsson ◽  
Lars Regnér ◽  
Johan Kärrholm
Keyword(s):  
Bone Loss ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Dual Energy ◽  
Femoral Bone ◽  
Posterior Stabilized ◽  
X Ray ◽  
Total Knee

scholarly journals An Approach to Developing Customized Total Knee Replacement Implants

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Xinyu Li ◽  
Changjiang Wang ◽  
Yuan Guo ◽  
Weiyi Chen
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Biomechanical Analysis ◽  
Implant Design ◽  
Patient Specific ◽  
3 Dimensional ◽  
Total Knee ◽  
Ct Data ◽  
Magnetic Resonance Imaging Mri ◽  
End Stage

Total knee replacement (TKR) has been performed for patients with end-stage knee joint arthritis to relieve pain and gain functions. Most knee replacement patients can gain satisfactory knee functions; however, the range of motion of the implanted knee is variable. There are many designs of TKR implants; it has been suggested by some researchers that customized implants could offer a better option for patients. Currently, the 3-dimensional knee model of a patient can be created from magnetic resonance imaging (MRI) or computed tomography (CT) data using image processing techniques. The knee models can be used for patient-specific implant design, biomechanical analysis, and creating bone cutting guide blocks. Researchers have developed patient-specific musculoskeletal lower limb model with total knee replacement, and the models can be used to predict muscle forces, joint forces on knee condyles, and wear of tibial polyethylene insert. These available techniques make it feasible to create customized implants for individual patients. Methods and a workflow of creating a customized total knee replacement implant for improving TKR kinematics and functions are discussed and presented in this paper.

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