scholarly journals Computed tomography based 3D printed patient specific blocks for total knee replacement

2018 ◽  
Vol 9 (3) ◽  
pp. 254-259 ◽  
Author(s):  
Raju Vaishya ◽  
Vipul Vijay ◽  
Abhishek Vaish ◽  
Amit K. Agarwal
Keyword(s):  
Computed Tomography ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Patient Specific ◽  
3D Printed ◽  
Total Knee

Neutrophil–Lymphocyte Ratio as a Predictor of Venous Thromboembolism after Total Knee Replacement

2019 ◽  
Author(s):  
Won-Woo Seo ◽  
Myung-Soo Park ◽  
Sung Eun Kim ◽  
Jun-Hee Lee ◽  
Dae-Gyun Park ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Venous Thromboembolism ◽  
Total Knee Replacement ◽  
Ct Scan ◽  
Knee Replacement ◽  
Independent Predictor ◽  
Characteristic Curve ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Total Knee

AbstractVenous thromboembolism (VTE) is a potentially serious complication after total knee replacement (TKR), and recent guideline recommends thromboprophylaxis for VTE after TKR. The neutrophil–lymphocyte ratio (NLR) has emerged as a simple and new prognostic biomarker for several cardiovascular diseases. This study was performed to investigate the precise incidence of postoperative VTE and the role of NLR for predicting VTE in patients receiving thromboprophylaxis after TKR. We retrospectively enrolled 264 patients undergoing TKR who underwent routine screening enhanced pulmonary artery and lower extremity venography computed tomography (CT) scan within 7 postoperative days. Biochemical tests were performed within 2 weeks prior to surgery, and the NLR was defined as the absolute neutrophil count in peripheral blood divided by lymphocyte count. All patients received thromboprophylaxis with enoxaparin postoperatively. Of 264 patients, 102 (38.6%) were diagnosed with deep vein thrombosis (DVT) or pulmonary embolism on CT scan. Preoperative NLR was significantly higher in patients with postoperative VTE compared with that in patients without VTE (2.57 ± 1.59 vs. 2.11 ± 1.10, p = 0.011). Receiver operating characteristic curve analysis showed that a preoperative NLR of 1.90 was the best cutoff value for the prediction of postoperative VTE (sensitivity 57.8%, specificity 55.6%, and area under curve 0.589). In the multivariate analysis, a preoperative NLR ≥1.90 was a sole independent predictor of postoperative VTE (odds ratio: 1.95, 95% computed tomography: 1.16–3.31, p = 0.013). The present study shows a higher incidence of VTE (38.6%) after TKR in patients receiving thromboprophylaxis than that reported in previous studies. Furthermore, preoperative NLR was significantly higher in patients with postoperative VTE, and a high preoperative NLR (≥1.90) was an independent predictor of VTE after TKR. NLR measurement may be a simple and useful method for the prediction of VTE in patients undergoing TKR.

Intra- and post-operative accuracy assessments of two different patient-specific instrumentation systems for total knee replacement

2013 ◽  
Vol 22 (3) ◽  
pp. 621-629 ◽  
Author(s):  
Andrea Ensini ◽  
Antonio Timoncini ◽  
Francesco Cenni ◽  
Claudio Belvedere ◽  
Francesca Fusai ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Patient Specific ◽  
Patient Specific Instrumentation ◽  
Total Knee ◽  
Accuracy Assessments

A review of rapid prototyped surgical guides for patient-specific total knee replacement

2012 ◽  
Vol 94-B (11) ◽  
pp. 1457-1461 ◽  
Author(s):  
S. P. Krishnan ◽  
A. Dawood ◽  
R. Richards ◽  
J. Henckel ◽  
A. J. Hart
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Patient Specific ◽  
Surgical Guides ◽  
Total Knee

scholarly journals Computed tomography is not necessary to assess rotation of the femoral component in navigation-assisted total knee replacement

2016 ◽  
Vol 44 (6) ◽  
pp. 1314-1322 ◽  
Author(s):  
Daniel Hernández-Vaquero ◽  
Alfonso Noriega-Fernandez ◽  
Ivan Perez-Coto ◽  
Manuel A. Sandoval García ◽  
Andres A. Sierra-Pereira ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Knee Replacement ◽  
Femoral Component ◽  
Knee Replacement ◽  
Transepicondylar Axis ◽  
Component Rotation ◽  
Preoperative Ct ◽  
Total Knee ◽  
The Mean ◽  
Ct Data

Objective To demonstrate that postoperative computed tomography (CT) is not needed if navigation is used to determine the rotational position of the femoral component during total knee replacement (TKR). Methods Preoperative CT, navigational, and postoperative CT data of 70 TKR procedures were analysed. The correlation between the rotational angulation of the femur measured by CT and that measured by perioperative navigation was examined. The correlation between the femoral component rotation determined by navigation and that determined by CT was also assessed. Results The mean femoral rotation determined by navigation was 2.64° ± 4.34°, while that shown by CT was 6.43° ± 1.65°. Postoperative rotation of the femoral component shown by CT was 3.09° ± 2.71°, which was closely correlated with the angle obtained through the intraoperative transepicondylar axis by navigation (Pearson’s R = 0.930). Conclusions Navigation can be used to collect the preoperative, intraoperative, and postoperative data and final position of the TKR. The rotation of the femoral component can be determined using navigation without the need for CT.

scholarly journals No radiological and clinical advantages with patient-specific positioning guides in total knee replacement

2017 ◽  
Vol 89 (1) ◽  
pp. 89-94 ◽  
Author(s):  
Justin A M J Van Leeuwen ◽  
Finnur Snorrason ◽  
Stephan M Röhrl
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Patient Specific ◽  
Total Knee

scholarly journals The surgeon plays an important role in size planning with patient specific instrumentation for total knee replacement.

10.29007/g13b ◽  
2018 ◽  
Author(s):  
Davide Cucchi ◽  
Riccardo Compagnoni ◽  
Paolo Ferrua ◽  
Alessandra Menon ◽  
Pietro Randelli
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Patient Specific ◽  
Component Position ◽  
Careful Evaluation ◽  
Tibial Tray ◽  
Component Size ◽  
Patient Specific Instrumentation ◽  
Total Knee

Component position and sizing in total knee replacement (TKR) could be improved by patient specific instrumentation (PSI). The purpose of the study was to evaluate the reliability of the manufacturer plan in predicting final component sizes for TKR.Forty-five TKRs were prospectively enrolled and data on component size were recorded from the initial manufacturer’s proposal, the final plan modified after surgeon’s and from the actually implanted prostheses.Pre-operative modifications were required in more than 50% of the cases, with the tibial tray size requiring more frequent changes. The surgeon’s planning showed a significantly higher accuracy than the manufacturer’s one regarding tibial tray size (p < 0.05) but not femoral components size (p: n.s.). Careful evaluation by an experienced knee surgeon is recommended when planning TKR with PSI.

scholarly journals Patient specific instrumentation influences hemoglobin decrease after total knee replacement.

10.29007/f8h2 ◽  
2018 ◽  
Author(s):  
Davide Cucchi ◽  
Beatrice Zanini ◽  
Paolo Ferrua ◽  
Riccardo Compagnoni ◽  
Alessandra Menon ◽  
...  
Keyword(s):  
Blood Loss ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Medullary Canal ◽  
Patient Specific ◽  
Reduce Blood Loss ◽  
Patient Specific Instrumentation ◽  
Significant Difference ◽  
Conventional Instrumentation ◽  
Total Knee

Patient Specific Instrumentation (PSI) may contribute to reduce blood loss after total knee replacement (TKR) by avoiding violation of the medullary canal. The purpose of the study was to compare the hemoglobin (Hb) decrease in two groups of patients undergoing TKR with PSI and conventional instrumentation.Pre- and post-operative blood samples were collected for twenty-two patients randomly assigned to receive a PSI-assisted or conventional TKR. Post- to preoperative Hb difference was calculated.A significant difference in Hb reduction in favor of the PSI group was registered on the last day of stay but not on the previous post-operative days: these promising results suggest a beneficial effect of PSI in blood loss reduction. PSI may hence be considered among the strategies available to control and reduce blood loss related to TKR.

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