The relationship between joint alignment and biomechanics in total knee arthroplasty: An in-vivo analysis

2015 ◽  
Vol 42 ◽  
pp. S23
Author(s):  
A. Metcalfe ◽  
J. Madete ◽  
D. Williams ◽  
P. Biggs ◽  
G. Whatling ◽  
...  
Author(s):  
Tomofumi Kage ◽  
Hiroshi Inui ◽  
Tetsuya Tomita ◽  
Takaharu Yamazaki ◽  
Shuji Taketomi ◽  
...  

AbstractBicruciate-stabilized total knee arthroplasty (BCS TKA) has been developed to improve TKA kinematic performance. However, the relationship between in vivo kinematics and patient-reported outcomes (PROs) has not been well described. This study was performed to clarify the relationship between in vivo kinematics and PROs in a cohort of patients undergoing BCS TKA. Forty knees were evaluated using a two-dimensional to three-dimensional registration technique obtained from sagittal plane fluoroscopy. In vivo kinematics including anteroposterior (AP) translation and tibiofemoral rotation were evaluated. Knee Society scores (KSSs) and Knee injury and Osteoarthritis Outcome Scores (KOOSs) were assessed before and after surgery. Relationships between tibiofemoral kinematics assessed with the knee in different positions of knee flexion and PROs were evaluated using Spearman's correlation analysis. The study demonstrated a significant negative correlation (r =  − 0.33) between medial AP translation from minimum flexion to 30 degrees flexion and postoperative KOOS activities of daily living subscale. A significant positive correlation (r = 0.51) was found between the femoral external rotation from minimum flexion to 30 degrees flexion and improvement of the KOOS pain subscale. No correlation was found between the lateral AP translation and PROs. Achieving medial AP and femoral external rotation stability in early flexion may be important in optimizing postoperative PROs.


2009 ◽  
Vol 91 (Suppl 6) ◽  
pp. 67-73 ◽  
Author(s):  
Yukihide Minoda ◽  
Akio Kobayashi ◽  
Hiroyoshi Iwaki ◽  
Kentarou Iwakiri ◽  
Fumiaki Inori ◽  
...  

The Knee ◽  
2018 ◽  
Vol 25 (6) ◽  
pp. 1247-1253 ◽  
Author(s):  
Hiroshi Inui ◽  
Shuji Taketomi ◽  
Ryota Yamagami ◽  
Kohei Kawaguchi ◽  
Keiu Nakazato ◽  
...  

Author(s):  
Jeffrey E. Bischoff ◽  
Justin S. Hertzler

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.


Author(s):  
Kartik M. Varadarajan ◽  
Angela Moynihan ◽  
Darryl D’Lima ◽  
Clifford W. Colwell ◽  
Harry E. Rubash ◽  
...  

Accurate knowledge of in vivo articular contact kinematics and contact forces is required to quantitatively understand factors limiting life of total knee arthroplasty (TKA) implants, such as polyethylene component wear and implant loosening [1]. Determination of in vivo tibiofemoral contact forces has been a challenging issue in biomechanics. Historically, instrumented tibial implants have been used to measure tibiofemoral forces in vitro [2] and computational models involving inverse dynamic optimization have been used to estimate joint forces in vivo [3]. Recently, D’Lima et al. reported the first in vivo measurement of 6DOF tibiofemoral forces via an instrumented implant in a TKA patient [4]. However this technique does not provide a direct estimation of tibiofemoral contact forces in the medial and lateral compartments. Recently, a dual fluoroscopic imaging system has been used to accurately determine tibiofemoral contact locations on the medial and lateral tibial polyethylene surfaces [5]. The objective of this study was to combine the dual fluoroscope technique and the instrumented TKAs to determine the dynamic 3D articular contact kinematics and contact forces on the medial and lateral tibial polyethylene surfaces during functional activities.


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